Optimizing Diagnostic Accuracy of Fine Needle Aspiration Biopsy Calcitonin Measurements in Detecting Medullary Thyroid Carcinoma
Authors' conclusion
The use of FNA-Ctn measured by ECLIA showed adequate diagnostic accuracy for MTC diagnosis. Moreover, it may be clinically useful for localization in multinodular goiter when lobectomy is considered.
Study context
- Population
- Patients with nodular or multinodular goiter, normal or elevated serum calcitonin (Ctn) and thyroidectomy indications286 nodules evaluated
- Participants
- 50 vs 105
- Comparison
- FNA-Ctn for medullary thyroid carcinoma (MTC) diagnosis vs final pathology
- MTCn = 50
- Controlsn = 105reference
- Outcome
- Diagnostic accuracy (sensitivity, specificity, area under the receiver operator curve (AUROC)) of FNA-Ctn for MTC diagnosis
Methodological detailscase-control nested in a prospective cohort, multicenter, controls sampled 1:2 by cumulative incidence sampling
- Case-control nested in a prospective cohort
- Multicenter
- Controls sampled 1:2 by cumulative incidence sampling
Performance
As reported in the abstract
FNA-Ctn diagnostic accuracy for MTC
| Test or model | AUC | Sensitivity (threshold ≥220 pg/mL) | Specificity (threshold ≥220 pg/mL) |
|---|---|---|---|
| FNA-Ctn | 0.99 (95% CI 0.98-1.0) | 100% | 98% |
FNA-Ctn
AUC0.99 (95% CI 0.98-1.0)
Sensitivity (threshold ≥220 pg/mL)100%
Specificity (threshold ≥220 pg/mL)98%
Further findings
Serum Ctn · significantly higher in cases
P < 0.001
| Outcome | P value |
|---|---|
| FNA-Ctn by noduleMTC nodules vs Non-MTC nodules · significantly higher in MTC nodules | P < 0.0001 |
- FNA-Ctn by nodule: MTC nodules median 3.100 (IQR 450–45,200) pg/mL
- FNA-Ctn by nodule: Non-MTC nodules median 0.5 (IQR 0.5–0.5) pg/mL
- FNA-Ctn by nodule: 63 MTC and 223 non-MTC nodules
FNA-Ctn in non-medullary nodules, 11 MTC patients with multinodular goiter
- FNA-Ctn significantly higher in non-medullary nodules in the same lobe as the MTC nodule
- P = 0.0002
Original publication
Optimizing Diagnostic Accuracy of Fine Needle Aspiration Biopsy Calcitonin Measurements in Detecting Medullary Thyroid Carcinoma. Thyroid. Published 4 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →