Combining Procalcitonin and Calcitonin for the Diagnosis of Medullary Thyroid Cancer: A Two‐Step Approach
Authors' conclusion
CT is more sensitive than ProCT as a diagnostic marker for MTC. However, a two-step approach using ProCT as a supplementary marker can help to refine the diagnosis avoiding overtreatment, particularly when CT serum levels lie between 10 and 100 pg/mL.
Study context
- Population
- Patients undergoing thyroidectomy in Padua, January 2023–June 2024; serum procalcitonin (ProCT) and calcitonin (CT) measured preoperatively23 with MTC
- Participants
- 478 patients
- Comparison
- ProCT vs CT for MTC diagnosis
- Outcome
- Identification of MTC by ProCT combined with CT, vs histological diagnosis
Methodological detailsprospective
- Prospective
Performance
As reported in the abstract
Diagnostic accuracy for MTC
| Strategy | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
| CT >10 pg/mL | 0.91 | 0.98 | 0.7 | 0.99 |
| ProCT >0.04 ng/mL | 0.87 | 0.96 | 0.56 | 0.99 |
| ProCT >0.07 ng/mL | 0.78 | 0.98 | 0.72 | 0.99 |
Sensitivity
CT >10 pg/mL0.91
ProCT >0.04 ng/mL0.87
ProCT >0.07 ng/mL0.78
Specificity
CT >10 pg/mL0.98
ProCT >0.04 ng/mL0.96
ProCT >0.07 ng/mL0.98
PPV
CT >10 pg/mL0.7
ProCT >0.04 ng/mL0.56
ProCT >0.07 ng/mL0.72
NPV
CT >10 pg/mL0.99
ProCT >0.04 ng/mL0.99
ProCT >0.07 ng/mL0.99
- MTC at histology
- 23/478 (4.8%)
Further findings
Correct MTC/non-MTC identification by ProCT (0.04 ng/mL cut-off) in patients with CT 10–100 pg/mL
- Correctly identified
- 17/21 (80.9%)
Original publication
Combining Procalcitonin and Calcitonin for the Diagnosis of Medullary Thyroid Cancer: A Two‐Step Approach. Clin Endocrinol (Oxf). Published 4 June 2025. doi:10.
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