Calcitonin as Biomarker for the Medullary Thyroid Carcinoma

  • Yoon Ju Bae
  • Michael Schaab
  • Juergen KratzschEmail author
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 204)


Calcitonin (CTN) is a polypeptide hormone consisting of 32 amino acids with a disulfide bridge between position 1 and 7 that is mainly produced by the C-cells of thyroid gland. The measurement of CTN concentrations in blood reflects C-cell activity and is performed in general by immunoassay methods. However, there are analytical, physiological, pharmacological, and pathological factors that can influence results of serum CTN values. Due to the influence of these factors, there is a high variability in assay-dependent cutoffs used to discriminate between MTC, C-cell hyperplasia (CCH), and the absence of the pathological impairment of C-cells. There is a lot of evidence that the measurement of serum CTN concentrations in patients with thyroid nodules can lead to an earlier diagnosis of MTC or CCH than the exclusive use of imaging procedures and/or fine-needle aspiration cytology. Basal CTN concentrations higher than 60–100 pg/mL are highly indicative for the diagnosis MTC. In the range between cutoff and 60 pg/mL CTN, both MTC and HCC may be a relevant diagnosis. PCT and CTN appear to have a comparable diagnostic capability to diagnose MTCs. However, “positive” PCT values of more than 50 pg/mL may be reached also in subclinical infections and will lead, therefore, to an overdiagnosis of the tumor. Pentagastrin- or calcium-stimulated serum CTN concentrations higher than cutoff values might improve diagnostics of MTC, but the non-availability of the first and the lacking of relevant cutoff values for the second tool favors the use of only basal values currently.


Calcitonin Procalcitonin Immunoassay Pentagastrin stimulation Calcium stimulation Cutoff 

List of Abbreviations


Area under the curve




Calcitonin gene-related peptide

1,25–OH–Vitamin D3





C-cell hyperplasia


Chronic kidney disease


Coefficients of variation


Fine-needle aspiration cytology


Histamine-2 receptor blockers


Immunoradiometric assay


Medullary thyroid carcinoma


Messenger ribonucleic acid


Nichols Institute Diagnostics






Positive predictive value


Proton pump inhibitor




Receiver operating curve


Reference Institute for Bioanalytics


World Health Organization


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Yoon Ju Bae
    • 1
  • Michael Schaab
    • 1
  • Juergen Kratzsch
    • 1
    Email author
  1. 1.Institut für Laboratoriumsmedizin, Klinische Chemie und Molekulare DiagnostikUniversität LeipzigLeipzigGermany

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