METHODS: 90 subjects undergone calcium-stimulated Ct for a suspected MTC in 5 Endocrine Units between 2010-2021 were retrospectively analyzed. Serum Ct concentrations were assessed by immunoradiometric (IRMA) or chemiluminescence (CLIA) assays.
RESULTS: MTC was diagnosed in 37 (41.1%) and excluded in 53 (58.9%) patients. The best calcium-stimulated Ct cut-off to identify MTC was 611 pg/mL in males (AUC =0.90, 95% CI (0.76;1) and 445 pg/mL in females (AUC=0.79, 95% CI (0.66;0.91). Logistic regression analysis showed that both basal (OR 1.01, P=0.003) and peak Ct after stimulation (OR 1.07, P=0.007) were significantly associated with MTC, together with sex (OR=0.06, P<0.001). The \"Ct assay\" variable was also considered in the logistic regression model, but it was not significantly associated with MTC (OR=0.93, P=0.919).
CONCLUSIONS: This study indicates that calcium test could be helpful to identify patients with early-stage MTC and those without MTC. A Ct value of 611 pg/mL in males and 445 pg/mL in females are proposed as the optimal Ct cut-offs at the stimulation test.
方法:对2010-2021年期间在5个内分泌单位中接受钙刺激的Ct疑似MTC患者进行回顾性分析。通过免疫放射(IRMA)或化学发光(CLIA)测定评估血清Ct浓度。
结果:在37例(41.1%)患者中诊断出MTC,在53例(58.9%)患者中排除MTC。识别MTC的最佳钙刺激Ct截止值为男性611pg/mL(AUC=0.90,95%CI(0.76;1)和女性445pg/mL(AUC=0.79,95%CI(0.66;0.91)。Logistic回归分析显示,刺激后基础(OR1.01,P=0.003)和峰值Ct(OR1.07,P=0.007)均与MTC显著相关。性别(OR=0.06,P<0.001)。在逻辑回归模型中也考虑了“Ct测定”变量,但与MTC无显著相关性(OR=0.93,P=0.919)。
结论:本研究表明,钙检测有助于识别早期MTC患者和无MTC患者。建议将雄性的Ct值为611pg/mL,雌性为445pg/mL,作为刺激测试中的最佳Ct截止值。