Calcitonin thresholds for prediction of medullary thyroid carcinoma and its clinical response in MEN2A gene carriers
Authors' conclusion
GCs with a preoperative bCTN between 12.6 and 28.3 ng/L have a very high probability of achieving complete biochemical and structural remission after surgery, even when a small intrathyroidal MTC is already present and independently from the RET germline mutation.
Study context
- Population
- MEN2A gene carriers who underwent surgery and were followed up at an Italian tertiary referral center, 1993–2024
- Participants
- 106 gene carriers
- Exposure
- Preoperative calcitonin thresholds for medullary thyroid cancer (MTC) diagnosis and excellent response
- Outcome
- Predictive value of preoperative CTN for MTC diagnosis and excellent response (ER)
Methodological detailsprospectively maintained database, single-centre, tertiary referral center
- Prospectively maintained database
- Single-centre
- Tertiary referral center
Main finding
As reported in the abstract
| Strategy | Sensitivity (MTC) | Sensitivity (excellent response (ER)) | Specificity (MTC) | Specificity (ER) |
|---|---|---|---|---|
| bCTN > 12.60 ng/L | 94.4% | — not stated in the abstract | 74.3% | — not stated in the abstract |
| bCTN < 28.25 ng/L | — not stated in the abstract | 76.8% | — not stated in the abstract | 95.5% |
Sensitivity (MTC)
bCTN > 12.60 ng/L94.4%
bCTN < 28.25 ng/L— not stated in the abstract
Sensitivity (excellent response (ER))
bCTN > 12.60 ng/L— not stated in the abstract
bCTN < 28.25 ng/L76.8%
Specificity (MTC)
bCTN > 12.60 ng/L74.3%
bCTN < 28.25 ng/L— not stated in the abstract
Specificity (ER)
bCTN > 12.60 ng/L— not stated in the abstract
bCTN < 28.25 ng/L95.5%
— not stated in the abstract
Observational data: associations, not effects.
Further findings
MTC vs C-cell hyperplasia (CCH) alone
- MTC
- 86 (81.1%)
- CCH alone
- 20 (18.9%)
- MTC patients older at RET screening and surgery and with higher preoperative bCTN and sCTN than CCH
Incomplete response (IR) · median follow-up 6.8 years
- IR
- 24/106 (22.9%)
- IR patients had higher preoperative bCTN and sCTN than ER patients
RET mutations
- RET V804M
- 36/106, 34.3%
- 634 codon
- 17/106, 16.2%
- Median age at surgery
- 39 years
Original publication
Calcitonin thresholds for prediction of medullary thyroid carcinoma and its clinical response in MEN2A gene carriers. J Clin Endocrinol Metab. Published 16 February 2026. doi:10.
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