Abstract：
BACKGROUND: Calcitonin is a sensitive marker for medullary thyroid carcinoma (MTC) diagnosis and postsurgical follow-up. This study aimed to define the gender and tumor size-specific calcitonin cutoff values for diagnosing MTC.
METHODS: This retrospective study recruited 95 MTC patients and 10,523 non-MTC patients who underwent thyroid nodule surgery at Zhongshan Hospital between January 2015 and June 2023. Receiver operating characteristic (ROC) curves were used to assess calcitonin cutoff values for diagnosing MTC.
RESULTS: Calcitonin levels in non-MTC patients were influenced by gender, CKD stage and age, with gender being the highest ranked predictor. In MTC patients, calcitonin levels were associated with tumor diameter, lymph node metastasis, and TNM stage. In the entire study population, calcitonin cutoff values to diagnose MTC were 17.75 pg/mL for males (sensitivity: 97.60%, specificity: 99.40%) and 7.15 pg/mL for females (sensitivity: 94.34%, specificity: 99.22%). In patients with a thyroid nodule diameter ≤10 mm, the calcitonin cutoff values to diagnose MTC were 17.50 pg/mL for males (sensitivity: 95.00%, specificity: 99.27%) and 7.15 pg/mL for females (sensitivity: 90.91%, specificity: 99.04%). In patients with a thyroid nodule diameter >10 mm, the calcitonin cutoff values to diagnose MTC were 104.80 pg/mL for males (sensitivity: 100.00%, specificity: 100.00%) and 32.60 pg/mL for females (sensitivity: 96.77%, specificity: 100.00%).
CONCLUSIONS: We have identified the gender and tumor size-specific cutoff values for the diagnosis of MTC. Cutoff values based on gender and tumor diameter may help to improve the accuracy of preoperative diagnosis of MTC, which is worth to be verified by future studies.
METHODS: This retrospective study recruited 95 MTC patients and 10,523 non-MTC patients who underwent thyroid nodule surgery at Zhongshan Hospital between January 2015 and June 2023. Receiver operating characteristic (ROC) curves were used to assess calcitonin cutoff values for diagnosing MTC.
RESULTS: Calcitonin levels in non-MTC patients were influenced by gender, CKD stage and age, with gender being the highest ranked predictor. In MTC patients, calcitonin levels were associated with tumor diameter, lymph node metastasis, and TNM stage. In the entire study population, calcitonin cutoff values to diagnose MTC were 17.75 pg/mL for males (sensitivity: 97.60%, specificity: 99.40%) and 7.15 pg/mL for females (sensitivity: 94.34%, specificity: 99.22%). In patients with a thyroid nodule diameter ≤10 mm, the calcitonin cutoff values to diagnose MTC were 17.50 pg/mL for males (sensitivity: 95.00%, specificity: 99.27%) and 7.15 pg/mL for females (sensitivity: 90.91%, specificity: 99.04%). In patients with a thyroid nodule diameter >10 mm, the calcitonin cutoff values to diagnose MTC were 104.80 pg/mL for males (sensitivity: 100.00%, specificity: 100.00%) and 32.60 pg/mL for females (sensitivity: 96.77%, specificity: 100.00%).
CONCLUSIONS: We have identified the gender and tumor size-specific cutoff values for the diagnosis of MTC. Cutoff values based on gender and tumor diameter may help to improve the accuracy of preoperative diagnosis of MTC, which is worth to be verified by future studies.
摘要：
背景：降钙素是甲状腺髓样癌（MTC）诊断和术后随访的敏感标志物。本研究旨在确定诊断MTC的性别和肿瘤大小特异性降钙素截止值。
方法：这项回顾性研究招募了2015年1月至2023年6月在中山医院接受甲状腺结节手术的95例MTC患者和10,523例非MTC患者。使用受试者工作特征(ROC)曲线来评估用于诊断MTC的降钙素截止值。
结果：非MTC患者的降钙素水平受性别影响，CKD分期和年龄,性别是排名最高的预测因子。在MTC患者中，降钙素水平与肿瘤直径相关，淋巴结转移,TNM阶段。在整个研究人群中，男性诊断MTC的降钙素临界值为17.75pg/mL（敏感性：97.60％，特异性：99.40％）和女性的7.15pg/mL（灵敏度：94.34％，特异性：99.22%）。甲状腺结节直径≤10mm的患者，男性诊断MTC的降钙素临界值为17.50pg/mL（敏感性：95.00%，特异性：99.27%）和女性7.15pg/mL（灵敏度：90.91%，特异性：99.04%）。甲状腺结节直径>10毫米的患者，男性诊断MTC的降钙素临界值为104.80pg/mL（敏感性：100.00%，特异性：100.00%）和女性32.60pg/mL（灵敏度：96.77%，特异性：100.00%）。
结论：我们已经确定了诊断MTC的性别和肿瘤大小特异性截止值。基于性别和肿瘤直径的截止值可能有助于提高MTC术前诊断的准确性。这是值得未来研究验证的。
方法：这项回顾性研究招募了2015年1月至2023年6月在中山医院接受甲状腺结节手术的95例MTC患者和10,523例非MTC患者。使用受试者工作特征(ROC)曲线来评估用于诊断MTC的降钙素截止值。
结果：非MTC患者的降钙素水平受性别影响，CKD分期和年龄,性别是排名最高的预测因子。在MTC患者中，降钙素水平与肿瘤直径相关，淋巴结转移,TNM阶段。在整个研究人群中，男性诊断MTC的降钙素临界值为17.75pg/mL（敏感性：97.60％，特异性：99.40％）和女性的7.15pg/mL（灵敏度：94.34％，特异性：99.22%）。甲状腺结节直径≤10mm的患者，男性诊断MTC的降钙素临界值为17.50pg/mL（敏感性：95.00%，特异性：99.27%）和女性7.15pg/mL（灵敏度：90.91%，特异性：99.04%）。甲状腺结节直径>10毫米的患者，男性诊断MTC的降钙素临界值为104.80pg/mL（敏感性：100.00%，特异性：100.00%）和女性32.60pg/mL（灵敏度：96.77%，特异性：100.00%）。
结论：我们已经确定了诊断MTC的性别和肿瘤大小特异性截止值。基于性别和肿瘤直径的截止值可能有助于提高MTC术前诊断的准确性。这是值得未来研究验证的。
