scholarly journals A Review of the Significance in Measuring Preoperative and Postoperative Carcinoembryonic Antigen (CEA) Values in Patients with Medullary Thyroid Carcinoma (MTC)

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 609
Author(s):  
Ioannis Passos ◽  
Elisavet Stefanidou ◽  
Soultana Meditskou-Eythymiadou ◽  
Maria Mironidou-Tzouveleki ◽  
Vasiliki Manaki ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Carcinoembryonic Antigen ◽  
Medullary Thyroid Carcinoma ◽  
Clinical Significance ◽  
Relevant Literature ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
C Cells ◽  
Gastrointestinal Malignancies ◽  
Medullary Thyroid

Background and Objectives: Medullary thyroid carcinoma (MTC) accounts for 1–2% of all thyroid malignancies, and it originates from parafollicular “C” cells. Carcinoembryonic antigen (CEA) is a tumor marker, mainly for gastrointestinal malignancies. There are references in literature where elevated CEA levels may be the first finding in MTC. The aim of this study is to determine the importance of measuring preoperative and postoperative CEA values in patients with MTC and to define the clinical significance of the correlation between CEA and the origin of C cells. Materials and Methods: The existing and relevant literature was reviewed by searching for articles and specific keywords in the scientific databases of PubMedCentraland Google Scholar (till December 2020). Results: CEA has found its place, especially at the preoperative level, in the diagnostic approach of MTC. Preoperative CEA values >30 ng/mL indicate extra-thyroid disease, while CEA values >100 ng/mL are associated with lymph node involvement and distant metastases. The increase in CEA values preoperatively is associated with larger size of primary tumor, presence of lymph nodes, distant metastases and a poorer prognosis. The clinical significance of CEA values for the surgeon is the optimal planning of surgical treatment. In the recent literature, C cells seem to originate from the endoderm of the primitive anterior gut at the ultimobranchial bodies’ level. Conclusions: Although CEA is not a specific biomarker of the disease in MTC, itsmeasurement is useful in assessing the progression of the disease. The embryonic origin of C cells could explain the increased CEA values in MTC.

A High Level of Carcinoembryonic Antigen as Initial Manifestation of Medullary Thyroid Carcinoma in a Patient With Subclinical Hyperthyroidism

2011 ◽  
Vol 96 (3) ◽  
pp. 254-259 ◽  
Author(s):  
Sami Akbulut ◽  
Nilgun Sogutcu
Keyword(s):  
Thyroid Carcinoma ◽  
Carcinoembryonic Antigen ◽  
Medullary Thyroid Carcinoma ◽  
High Serum ◽  
Subclinical Hyperthyroidism ◽  
Initial Manifestation ◽  
Gastrointestinal Malignancies ◽  
Medullary Thyroid ◽  
Positron Emission ◽  
Serum Cea

Abstract Carcinoembryonic antigen (CEA), a tumor marker with a glycoprotein structure, is frequently used in follow-up gastrointestinal malignancies. CEA levels may also increase in neuroendocrine tumors, including medullary thyroid carcinoma (MTC), and in some benign diseases. Patients whose blood tests show high CEA levels should have additional tests regarding MTC. Although MTC comprises only 3%–11% of all thyroid cancers, it should be tested because it has a poor prognosis and may accompany multiple endocrine neoplasia. We present the case of a 76-year-old man with subclinical hyperthyroidism with sporadic MTC who presented with initial high serum CEA levels. He underwent total thyroidectomy and left modified neck dissection. Pathologic specimens stained strongly for CEA. The patient's blood was analyzed for mutations in exons 10, 11, 13, 14, 15, and 16, but the RET proto-oncogene revealed no mutations. The patient was regularly followed by measurement of serum CEA levels and performance of positron emission tomography–computed tomography. Seventeen months after surgery, the patient has remained well and showed no signs of tumor recurrence.

131I-MIBG as a treatment in medullary thyroid carcinoma with distant metastases.

2018 ◽  
Author(s):  
Nerea Utrilla Uriarte ◽  
Pedro Gonzalez Fernandez ◽  
Alba Esteban Figueruelo ◽  
Marina Nevares Herrero ◽  
Javier Santamaria Sandi
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Distant Metastases ◽  
Medullary Thyroid ◽  
131I Mibg

Expression of laminin-2 by normal and neoplastic rat C cells during the development of medullary thyroid carcinoma

1999 ◽  
Vol 434 (4) ◽  
pp. 325-332 ◽  
Author(s):  
Fatima Lekmine ◽  
Hélène Feracci ◽  
Gérard Milhaud ◽  
Françoise Treilhou-Lahille ◽  
N. Jeanne
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
C Cells ◽  
Medullary Thyroid

scholarly journals Medullary thyroid carcinoma: recent advances in identification, treatment, and prognosis

2021 ◽  
Vol 12 ◽  
pp. 204201882110496
Author(s):  
Marisa A. Bartz-Kurycki ◽  
Omowunmi E. Oluwo ◽  
Lilah F. Morris-Wiseman
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Distant Metastases ◽  
Hereditary Disease ◽  
Patient Specific ◽  
Medullary Thyroid ◽  
Recent Advances ◽  
Initial Surgery ◽  
Biochemical Testing ◽  
Thyroid Malignancies

Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor that represents <5% of all thyroid malignancies and is generally more aggressive than differentiated thyroid cancer. The aim of this study is to provide an update, through review of clinical studies of patients with MTC published between January 1, 2016, and June 1, 2021, on recent advances in the diagnosis and treatment of MTC. This review focuses on updates in biochemical testing, imaging, hereditary disease, surgical management, adjuvant therapies, and prognosis. Recent advances reviewed herein have sought to diagnose MTC at earlier stages of disease, predict when patients with a hereditary syndrome may develop MTC, use functional imaging to assess for distant metastases, perform optimal initial surgery with appropriate lymphadenectomy, employ targeted systemic therapies for patients with progressive metastatic disease, and better predict patient-specific outcomes.

scholarly journals Progression of medullary thyroid carcinoma: assessment with calcitonin and carcinoembryonic antigen doubling times

2008 ◽  
Vol 158 (2) ◽  
pp. 239-246 ◽  
Author(s):  
Anne Laure Giraudet ◽  
Abir Al Ghulzan ◽  
Anne Aupérin ◽  
Sophie Leboulleux ◽  
Ahmed Chehboun ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Carcinoembryonic Antigen ◽  
Disease Progression ◽  
Medullary Thyroid Carcinoma ◽  
Stable Disease ◽  
Progressive Disease ◽  
Tumor Burden ◽  
Ki 67 ◽  
Medullary Thyroid ◽  
Doubling Times

ObjectiveThe progression of medullary thyroid cancer is difficult to assess with imaging modalities; we studied the interest of calcitonin and carcinoembryonic antigen (CEA) doubling times and of Ki-67 labeling and mitotic index (MI).Patients and methodsFifty-five consecutive medullary thyroid carcinoma (MTC) patients with elevated calcitonin levels underwent repeated imaging studies in order to assess tumor burden and progression status. We looked for relationships between tumor burden and levels of calcitonin and CEA and between progression status according to the response evaluation criteria in solid tumors (RECIST) and calcitonin and CEA doubling times, and Ki-67 labeling and MI.ResultsThe calcitonin and CEA levels were correlated with tumor burden. Ten patients with calcitonin levels below 816 pg/ml had no imaged tumor foci. Among the 45 patients with imaged tumor foci, 19 had stable disease and 26 had progressive disease, according to the RECIST. The calcitonin and CEA doubling times were strongly related to disease progression, with very few overlaps: 94% of patients with doubling times shorter than 25 months had progressive disease and 86% of patients with doubling times longer than 24 months had stable disease. Ki-67 labeling and MI were not significantly associated with disease progression.ConclusionFor MTC patients, the doubling times of both calcitonin and CEA are efficient tools for assessing tumor progression.

Medullary thyroid carcinoma

2011 ◽  
pp. 625-630
Author(s):  
Friedhelm Raue ◽  
Karin Frank-Raue
Keyword(s):  
Sex Ratio ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Hereditary Disease ◽  
C Cells ◽  
Biochemical Screening ◽  
Medullary Thyroid ◽  
Histological Features ◽  
Sporadic Disease ◽  
Male To Female

Medullary thyroid carcinoma (MTC) is a rare calcitonin-secreting tumour of the parafollicular or C cells of the thyroid. As the C cells originate from the embryonic neural crest, MTC often have the clinical and histological features of neuroendocrine tumours. They account for 8–12% of all thyroid carcinomas and occur in both sporadic and hereditary forms (1). The majority of patients have sporadic MTC (70%), while 30% have hereditary MTC. The sex ratio in sporadic MTC is 1:1.3 (male to female), while both sexes are nearly equally affected in the familial variety (2). The highest incidence of sporadic disease occurs in the fifth decade of life, while hereditary disease can be diagnosed earlier, depending on the possibility of genetic and biochemical screening.

scholarly journals Polymorphisms of cell cycle control genes influence the development of sporadic medullary thyroid carcinoma

2014 ◽  
Vol 171 (6) ◽  
pp. 761-767 ◽  
Author(s):  
R B Barbieri ◽  
N E Bufalo ◽  
R Secolin ◽  
L V M Assumpção ◽  
R M B Maciel ◽  
...  
Keyword(s):  
Cell Cycle ◽  
Regression Analysis ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Cell Cycle Control ◽  
Multivariate Logistic Regression Analysis ◽  
Distant Metastases ◽  
Genetic Profile ◽  
Sporadic Medullary Thyroid Carcinoma ◽  
Medullary Thyroid

BackgroundThe role of key cell cycle regulation genes such as, CDKN1B, CDKN2A, CDKN2B, and CDKN2C in sporadic medullary thyroid carcinoma (s-MTC) is still largely unknown.MethodsIn order to evaluate the influence of inherited polymorphisms of these genes on the pathogenesis of s-MTC, we used TaqMan SNP genotyping to examine 45 s-MTC patients carefully matched with 98 controls.ResultsA multivariate logistic regression analysis demonstrated that CDKN1B and CDKN2A genes were related to s-MTC susceptibility. The rs2066827*GT+GG CDKN1B genotype was more frequent in s-MTC patients (62.22%) than in controls (40.21%), increasing the susceptibility to s-MTC (OR=2.47; 95% CI=1.048–5.833; P=0.038). By contrast, the rs11515*CG+GG of CDKN2A gene was more frequent in the controls (32.65%) than in patients (15.56%), reducing the risk for s-MTC (OR=0.174; 95% CI=0.048–0.627; P=0.0075). A stepwise regression analysis indicated that two genotypes together could explain 11% of the total s-MTC risk. In addition, a relationship was found between disease progression and the presence of alterations in the CDKN1A (rs1801270), CDKN2C (rs12885), and CDKN2B (rs1063192) genes. WT rs1801270 CDKN1A patients presented extrathyroidal tumor extension more frequently (92%) than polymorphic CDKN1A rs1801270 patients (50%; P=0.0376). Patients with the WT CDKN2C gene (rs12885) presented larger tumors (2.9±1.8 cm) than polymorphic patients (1.5±0.7 cm; P=0.0324). On the other hand, patients with the polymorphic CDKN2B gene (rs1063192) presented distant metastases (36.3%; P=0.0261).ConclusionIn summary, we demonstrated that CDKN1B and CDKN2A genes are associated with susceptibility, whereas the inherited genetic profile of CDKN1A, CDKN2B, and CDKN2C is associated with aggressive features of tumors. This study suggests that profiling cell cycle genes may help define the risk and characterize s-MTC aggressiveness.

Genetic Testing in Medullary Thyroid Carcinoma Syndromes: Mutation Types and Clinical Significance

1997 ◽  
Vol 72 (5) ◽  
pp. 430-436 ◽  
Author(s):  
Hassan M. Heshmati ◽  
Hossein Gharib ◽  
Sundeep Khosla ◽  
Haitham S. Abu-Lebdeh ◽  
Noralane M. Lindor ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Clinical Significance ◽  
Medullary Thyroid
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