Twenty years of experience with the preoperative diagnosis of medullary cancer in a moderately iodine-deficient region

Tamas Solymosi, Gyula Lukacs Toth, Dezso Nagy, I. Gál

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background. There is a current debate in the medical literature about plasma calcitonin screening in patients with nodular goiter (NG). We decided on analyzing our 20-year experience with patients in an iodine-deficient region (ID). Patients and Methods. 22,857 consecutive patients with NG underwent ultrasonography and aspiration cytology (FNAC). If FNAC raised suspicion of medullary cancer (MTC), the serum calcitonin was measured. Results. 4,601 patients underwent surgery; there were 23 patients among them who had MTC (0.1% prevalence). Significantly more MTC cases were diagnosed cytologically in the second decade than in the first: 11/12 and 6/11, respectively. The frozen section was of help in 2 cases out of 3. Two patients suffered from a 3-year delay in proper therapy, and reoperation was necessary in 1 case. FNAC raised the suspicion of MTC in 20 cases that were later histologically verified and did not present MTC. The diagnostic accuracy of FNAC in diagnosing MTC was 99.2%. Two false-positive serum calcitonin tests (one of them in a hemodialyzed patient) and one false-negative serum calcitonin test occurred in 40 cases. Conclusion. Regarding the low prevalence of MTC in ID regions, calcitonin screening of all NG patients does not only appear superfluously but may have more disadvantages than advantages.

Original languageEnglish
Article number571606
JournalInternational Journal of Endocrinology
Volume2013
DOIs
Publication statusPublished - 2013

Fingerprint

Iodine
Calcitonin
Nodular Goiter
Neoplasms
Serum
Frozen Sections
Reoperation
Cell Biology
Ultrasonography

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Twenty years of experience with the preoperative diagnosis of medullary cancer in a moderately iodine-deficient region. / Solymosi, Tamas; Lukacs Toth, Gyula; Nagy, Dezso; Gál, I.

In: International Journal of Endocrinology, Vol. 2013, 571606, 2013.

Research output: Contribution to journalArticle

@article{31c83d1bc5334c759c4f99dc0d67d48a,
title = "Twenty years of experience with the preoperative diagnosis of medullary cancer in a moderately iodine-deficient region",
abstract = "Background. There is a current debate in the medical literature about plasma calcitonin screening in patients with nodular goiter (NG). We decided on analyzing our 20-year experience with patients in an iodine-deficient region (ID). Patients and Methods. 22,857 consecutive patients with NG underwent ultrasonography and aspiration cytology (FNAC). If FNAC raised suspicion of medullary cancer (MTC), the serum calcitonin was measured. Results. 4,601 patients underwent surgery; there were 23 patients among them who had MTC (0.1{\%} prevalence). Significantly more MTC cases were diagnosed cytologically in the second decade than in the first: 11/12 and 6/11, respectively. The frozen section was of help in 2 cases out of 3. Two patients suffered from a 3-year delay in proper therapy, and reoperation was necessary in 1 case. FNAC raised the suspicion of MTC in 20 cases that were later histologically verified and did not present MTC. The diagnostic accuracy of FNAC in diagnosing MTC was 99.2{\%}. Two false-positive serum calcitonin tests (one of them in a hemodialyzed patient) and one false-negative serum calcitonin test occurred in 40 cases. Conclusion. Regarding the low prevalence of MTC in ID regions, calcitonin screening of all NG patients does not only appear superfluously but may have more disadvantages than advantages.",
author = "Tamas Solymosi and {Lukacs Toth}, Gyula and Dezso Nagy and I. G{\'a}l",
year = "2013",
doi = "10.1155/2013/571606",
language = "English",
volume = "2013",
journal = "International Journal of Endocrinology",
issn = "1687-8337",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - Twenty years of experience with the preoperative diagnosis of medullary cancer in a moderately iodine-deficient region

AU - Solymosi, Tamas

AU - Lukacs Toth, Gyula

AU - Nagy, Dezso

AU - Gál, I.

PY - 2013

Y1 - 2013

N2 - Background. There is a current debate in the medical literature about plasma calcitonin screening in patients with nodular goiter (NG). We decided on analyzing our 20-year experience with patients in an iodine-deficient region (ID). Patients and Methods. 22,857 consecutive patients with NG underwent ultrasonography and aspiration cytology (FNAC). If FNAC raised suspicion of medullary cancer (MTC), the serum calcitonin was measured. Results. 4,601 patients underwent surgery; there were 23 patients among them who had MTC (0.1% prevalence). Significantly more MTC cases were diagnosed cytologically in the second decade than in the first: 11/12 and 6/11, respectively. The frozen section was of help in 2 cases out of 3. Two patients suffered from a 3-year delay in proper therapy, and reoperation was necessary in 1 case. FNAC raised the suspicion of MTC in 20 cases that were later histologically verified and did not present MTC. The diagnostic accuracy of FNAC in diagnosing MTC was 99.2%. Two false-positive serum calcitonin tests (one of them in a hemodialyzed patient) and one false-negative serum calcitonin test occurred in 40 cases. Conclusion. Regarding the low prevalence of MTC in ID regions, calcitonin screening of all NG patients does not only appear superfluously but may have more disadvantages than advantages.

AB - Background. There is a current debate in the medical literature about plasma calcitonin screening in patients with nodular goiter (NG). We decided on analyzing our 20-year experience with patients in an iodine-deficient region (ID). Patients and Methods. 22,857 consecutive patients with NG underwent ultrasonography and aspiration cytology (FNAC). If FNAC raised suspicion of medullary cancer (MTC), the serum calcitonin was measured. Results. 4,601 patients underwent surgery; there were 23 patients among them who had MTC (0.1% prevalence). Significantly more MTC cases were diagnosed cytologically in the second decade than in the first: 11/12 and 6/11, respectively. The frozen section was of help in 2 cases out of 3. Two patients suffered from a 3-year delay in proper therapy, and reoperation was necessary in 1 case. FNAC raised the suspicion of MTC in 20 cases that were later histologically verified and did not present MTC. The diagnostic accuracy of FNAC in diagnosing MTC was 99.2%. Two false-positive serum calcitonin tests (one of them in a hemodialyzed patient) and one false-negative serum calcitonin test occurred in 40 cases. Conclusion. Regarding the low prevalence of MTC in ID regions, calcitonin screening of all NG patients does not only appear superfluously but may have more disadvantages than advantages.

UR - http://www.scopus.com/inward/record.url?scp=84875446327&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875446327&partnerID=8YFLogxK

U2 - 10.1155/2013/571606

DO - 10.1155/2013/571606

M3 - Article

C2 - 23533405

AN - SCOPUS:84875446327

VL - 2013

JO - International Journal of Endocrinology

JF - International Journal of Endocrinology

SN - 1687-8337

M1 - 571606

ER -