Introduction: Association between hypercalcitoninemia and pathological conditions such as autoimmune thyroiditis (AIT) or differentiated thyroid carcinoma (DTC) has been addressed, with conflicting results. We evaluated the prevalence and the clinical relevance of elevated basal serum calcitonin (CT) levels in non-neoplastic (nodular goiter [NG] and AIT) and neoplastic thyroid diseases (DTC). Methods: We retrospectively evaluated 3,250 consecutive patients with thyroid nodular disease who underwent fine-needle aspiration cytology with adequate sample. After exclusion of medullary thyroid cancer (MTC) patients were divided according to the presence/absence of thyroid autoimmunity into NG or nodular autoimmune thyroiditis (N-AIT) and, according to cytological results, in benign or suspicious/malignant nodules. Results: One hundred ninety-seven/3,250 patients (6.0%) showed CT level #x3e;10 pg/mL. In 11/3,250 (0.3%) cases, a final histological diagnosis of MTC was made, while the remaining 186/3,250 patients (5.7%) had non-MTC-related hypercalcitoninemia (CT #x3e; 10 pg/mL). According to cytological diagnosis, the rate of hypercalcitoninemia was similar in class II and class V–VI groups (5.4 vs. 6.9%, p = 0.4). The occurrence of hypercalcitoninemia was significantly higher in patients with NG (166/2,634 [6.3%]) than in patients with N-AIT (20/605 [3.3%]) (p = 0.004). However, after matching by sex, no difference was found between the 2 groups (NG and N-AIT). These results were confirmed in 598 patients submitted to surgery. Conclusions: AIT and DTC seem not to affect serum CT levels in patients with thyroid nodules. Therefore, hypercalcitoninemia, in these patients, should be submitted to the same diagnostic workup than patients without AIT or DTC.
Eur Thyroid J

中文翻译：

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甲状腺疾病中的降钙素水平不受自身免疫性甲状腺炎或分化型甲状腺癌的影响

简介：高降钙素血症与自身免疫性甲状腺炎 (AIT) 或分化型甲状腺癌 (DTC) 等病理状况之间的关联已得到解决，但结果相互矛盾。我们评估了基础血清降钙素 (CT) 水平升高在非肿瘤性（结节性甲状腺肿 [NG] 和 AIT）和肿瘤性甲状腺疾病 (DTC) 中的患病率和临床相关性。方法：我们回顾性评估了 3,250 名连续接受细针抽吸细胞学检查且样本充足的甲状腺结节病患者。在排除甲状腺髓样癌 (MTC) 后，根据是否存在甲状腺自身免疫将患者分为 NG 或结节性自身免疫性甲状腺炎 (N-AIT)，并根据细胞学结果分为良性或可疑/恶性结节。结果： 197 名/3,250 名患者 (6.0%) 显示 CT 水平 #x3e;10 pg/mL。在 11/3,250 (0.3%) 例患者中，最终组织学诊断为 MTC，而其余 186/3,250 例患者 (5.7%) 患有非 MTC 相关的高降钙素血症 (CT #x3e; 10 pg/mL)。根据细胞学诊断，II 类和 V-VI 类组的高降钙素血症发生率相似（5.4% vs. 6.9%，p = 0.4)。NG 患者的高降钙素血症发生率（166/2,634 [6.3%]）明显高于 N-AIT 患者（20/605 [3.3%]）（p = 0.004）。然而，在按性别匹配后，两组（NG 和 N-AIT）之间没有发现差异。这些结果在 598 名接受手术的患者中得到证实。结论： AIT 和 DTC 似乎不影响甲状腺结节患者的血清 CT 水平。因此，对于这些患者的高降钙素血症，应该与没有 AIT 或 DTC 的患者进行相同的诊断检查。
欧洲甲状腺杂志