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Calcitonin levels in autoimmune atrophic gastritis-related hypergastrinemia

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Abstract

Purpose

Calcitonin (Ct) is currently the most sensitive biochemical marker of C-cell disease (medullary thyroid cancer [MTC] and C-cell hyperplasia), but its specificity is relatively low. Our aim was to examine whether autoimmune atrophic gastritis (AAG) and chronic hypergastrinemia, with or without chronic autoimmune thyroiditis (AT), are conditions associated with increased Ct levels.

Methods

Three groups of patients were consecutively enrolled in this  multicentric study: group A consisted of patients with histologically-proven AAG (n = 13; 2 males, 11 females); group B fulfilled the criteria for group A but also had AT (n = 92; 15 males, 77 females); and group C included patients with AT and without AAG (n = 37; 6 males, 31 females).

Results

Median Ct levels did not differ between the three groups. Ct levels were undetectable in: 8/13 cases (61.5%) in group A, 70/92 (76.1%) in group B, and 27/37 (73.0%) in group C. They were detectable but ≤ 10 ng/L in 4/13 (30.8%), 20/92 (21.7%) and 7/37 (18.9%) cases, respectively; and they were > 10 ng/L in 1/13 (7.7%), 2/92 (2.2%) and 3/37 (8.1%) cases, respectively (P = 0.5). Only three patients had high Ct levels (> 10 ng/L) and high gastrin levels and had an MTC. There was no correlation between Ct and gastrin levels (P = 0.353, r = 0.0785).

Conclusions

High gastrin levels in patients with AAG do not explain any hypercalcitoninemia, regardless of whether patients have AT or not. This makes it mandatory to complete the diagnostic process to rule out MTC in patients with high Ct levels and AAG.

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Data availability

The data are available from the corresponding author upon reasonable individual request.

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Acknowledgements

We thank Frances Coburn for text editing and the DIMAR department (DImed and MAlattie Rare) for its support for research on rare diseases.

Funding

No funds, grants, or other support was received.

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Author notes

  1. Simona Censi and Sofia Carducci have contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy

    S. Censi, S. Carducci, J. Manso, C. Sabbadin, I. Piva, S. Barollo, L. Bertazza, C. Scaroni & C. Mian

  2. Endocrinologia, Diabetologia E Malattie del Metabolismo, Azienda Ospedaliera Universitaria Integrata, Verona, Italy

    G. Zoppini, A. Toffalini & V. Tonelli

  3. Department of Woman’s and Child ’s Health-Pediatric Endocrinology and Adolescence Unit, University Hospital of Padua, Padua, Italy

    J. Manso

  4. Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy

    F. Galuppini & G. Pennelli

  5. Gastroenterology Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy

    V. Pilotto & F. Farinati

  6. Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy

    D. Basso

  7. Dipartimento Di Scienze Mediche, Chirurgiche E Della Salute, Università Degli Studi Di Trieste, Trieste, Italy

    B. Fabris & S. Bernardi

  8. Department of Medical and Surgical Sciences, Endocrinology Unit, Via Ospedale N.105, 35128, Padua, Italy

    C. Mian

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Contributions

SC and CM: study concept and design, substantial contributions to data acquisition, analysis and interpretation, drafting of the manuscript, final approval of the version to be published and agreement with all aspects of the work; SF: study concept and design, substantial contributions to data acquisition and analysis, drafting of the manuscript, final approval of the version to be published and agreement with all aspects of the work; GZ, AF, VT, JM, ChS, VP, BF, SB, IP: substantial contributions to data acquisition and interpretation, critical revision of the manuscript; LB, SB, FG, GP; DB, FF and CaS,: substantial contributions to data acquisition, analysis and interpretation, critical revision of the manuscript, final approval of the version to be published and agreement with all aspects of the work; FF, BF, CaS and GZ: study concept and design, substantial contributions to data acquisition and analysis, final approval of the version to be published and agreement with all aspects of the work; FG, GP and AF: substantial contributions to data acquisition, critical revision of the manuscript, final approval of the version to be published and agreement with all aspects of the work. All Authors approved the version to be published, in agreement with all aspects of the work.

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Correspondence to C. Mian.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

The study was approved by the Local Ethical Committee at Padua Hospital (the institution proposing and leading the present study)—Comitato Etico per la Sperimentazione Clinica (CESC) approval code: 3312/AO/14 prot. 0034435.

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The study was performed in accordance with the guidelines of the Helsinki Declaration.

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Censi, S., Carducci, S., Zoppini, G. et al. Calcitonin levels in autoimmune atrophic gastritis-related hypergastrinemia. J Endocrinol Invest 47, 357–365 (2024). https://doi.org/10.1007/s40618-023-02152-x

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