Calcitonin levels in autoimmune atrophic gastritis-related hypergastrinemia.
Autoimmune atrophic gastritis
Calcitonin
Gastrin
Hypergastrinemia
Journal
Journal of endocrinological investigation
ISSN: 1720-8386
Titre abrégé: J Endocrinol Invest
Pays: Italy
ID NLM: 7806594
Informations de publication
Date de publication:
17 Jul 2023
17 Jul 2023
Historique:
received:
28
02
2023
accepted:
02
07
2023
medline:
18
7
2023
pubmed:
18
7
2023
entrez:
17
7
2023
Statut:
aheadofprint
Résumé
Calcitonin (Ct) is currently the most sensitive biochemical marker of C-cell disease (medullary thyroid cancer [MTC] and C-cell hyperplasia), but its specificity is relatively low. Our aim was to examine whether autoimmune atrophic gastritis (AAG) and chronic hypergastrinemia, with or without chronic autoimmune thyroiditis (AT), are conditions associated with increased Ct levels. Three groups of patients were consecutively enrolled in this multicentric study: group A consisted of patients with histologically-proven AAG (n = 13; 2 males, 11 females); group B fulfilled the criteria for group A but also had AT (n = 92; 15 males, 77 females); and group C included patients with AT and without AAG (n = 37; 6 males, 31 females). Median Ct levels did not differ between the three groups. Ct levels were undetectable in: 8/13 cases (61.5%) in group A, 70/92 (76.1%) in group B, and 27/37 (73.0%) in group C. They were detectable but ≤ 10 ng/L in 4/13 (30.8%), 20/92 (21.7%) and 7/37 (18.9%) cases, respectively; and they were > 10 ng/L in 1/13 (7.7%), 2/92 (2.2%) and 3/37 (8.1%) cases, respectively (P = 0.5). Only three patients had high Ct levels (> 10 ng/L) and high gastrin levels and had an MTC. There was no correlation between Ct and gastrin levels (P = 0.353, r = 0.0785). High gastrin levels in patients with AAG do not explain any hypercalcitoninemia, regardless of whether patients have AT or not. This makes it mandatory to complete the diagnostic process to rule out MTC in patients with high Ct levels and AAG.
Identifiants
pubmed: 37460914
doi: 10.1007/s40618-023-02152-x
pii: 10.1007/s40618-023-02152-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).
Références
Verbeek HHG, de Groot JWB, Sluiter WJ et al (2020) Calcitonin testing for detection of medullary thyroid cancer in people with thyroid nodules. Cochrane Database of Syst Rev. https://doi.org/10.1002/14651858.CD010159.pub2
doi: 10.1002/14651858.CD010159.pub2
Censi S, Cavedon E, Fernando SW et al (2016) Calcitonin measurement and immunoassay interference: a case report and literature review. Clin Chem Lab Med 1(54):1861–1870. https://doi.org/10.1515/cclm-2015-1161
doi: 10.1515/cclm-2015-1161
Wells SA, Asa SL, Dralle H et al (2015) Revised American thyroid association guidelines for the management of medullary thyroid carcinoma. Thyroid 25:567–610. https://doi.org/10.1089/thy.2014.0335
doi: 10.1089/thy.2014.0335
pubmed: 25810047
pmcid: 4490627
Rosario PW, Calsolari MR (2013) Influence of chronic autoimmune thyroiditis and papillary thyroid cancer on serum calcitonin levels. Thyroid 23:671–674. https://doi.org/10.1089/THY.2012.0564
doi: 10.1089/THY.2012.0564
pubmed: 23327335
Maino F, Dalmiglio C, Benenati N et al (2021) Calcitonin levels in thyroid disease are not affected by autoimmune thyroiditis or differentiated thyroid carcinoma. Eur Thyroid J 10:295–305. https://doi.org/10.1159/000511080
doi: 10.1159/000511080
pubmed: 34395301
Grani G, Nesca A, del Sordo M et al (2012) Interpretation of serum calcitonin in patients with chronic autoimmune thyroiditis. Endocr Relat Cancer 19:345–349. https://doi.org/10.1530/ERC-12-0013
doi: 10.1530/ERC-12-0013
pubmed: 22399011
Wells SA, Baylin SB, Linehan WM et al (1978) Provocative agents and the diagnosis of medullary carcinoma of the thyroid gland. Ann Surg 188:139–141. https://doi.org/10.1097/00000658-197808000-00002
doi: 10.1097/00000658-197808000-00002
pubmed: 686877
pmcid: 1396745
Dockray GJ, Varro A, Dimaline R, Wang T (2001) The gastrins: their production and biological activities. Annu Rev Physiol 63:119–139. https://doi.org/10.1146/annurev.physiol.63.1.119
doi: 10.1146/annurev.physiol.63.1.119
pubmed: 11181951
Heynen G, Brassine A, Daubresse JC et al (1981) Lack of clinical and physiological relationship between gastrin and calcitonin in man. Eur J Clin Invest 11:331–335. https://doi.org/10.1111/J.1365-2362.1981.TB02125.X
doi: 10.1111/J.1365-2362.1981.TB02125.X
pubmed: 6795050
Biancotti R, Dal Pozzo CA, Parente P et al (2022) The histopathological landscape of precursor lesions of gastro-entero-pancreatic neuroendocrine neoplasms. Dig Dis 41:34–48. https://doi.org/10.1159/000525421
doi: 10.1159/000525421
pubmed: 35816999
Rodriguez-Castro KI, Franceschi M, Miraglia C et al (2018) Autoimmune diseases in autoimmune atrophic gastritis. Acta Biomed 89:100–103. https://doi.org/10.23750/ABM.V89I8-S.7919
doi: 10.23750/ABM.V89I8-S.7919
pubmed: 30561426
Cellini M, Santaguida MG, Virili C et al (2017) Hashimoto’s thyroiditis and autoimmune gastritis. Front Endocrinol 8:92. https://doi.org/10.3389/FENDO.2017.00092
doi: 10.3389/FENDO.2017.00092
Rugge M, Meggio A, Pennelli G et al (2007) Gastritis staging in clinical practice: the OLGA staging system. Gut 56:631–636. https://doi.org/10.1136/GUT.2006.106666
doi: 10.1136/GUT.2006.106666
pubmed: 17142647
Pennelli G, Grillo F, Galuppini F et al (2020) Gastritis: update on etiological features and histological practical approach. Pathologica 112:153–165. https://doi.org/10.32074/1591-951X-163
doi: 10.32074/1591-951X-163
pubmed: 33179619
pmcid: 7931571
Gharib H, Papini E, Garber JR et al (2016) American association of clinical endocrinologists, american college of endocrinology, and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules-2016 update. Endocr Pract 22(5):622–639. https://doi.org/10.4158/EP161208.GL
doi: 10.4158/EP161208.GL
pubmed: 27167915
d’Herbomez M, Caron P, Bauters C et al (2007) Reference range of serum calcitonin levels in humans: influence of calcitonin assays, sex, age, and cigarette smoking. Eur J Endocrinol 157:749–755. https://doi.org/10.1530/EJE-07-0566
doi: 10.1530/EJE-07-0566
pubmed: 18057382
Costante G, Durante C, Francis Z et al (2009) Determination of calcitonin levels in C-cell disease: clinical interest and potential pitfalls. Nat Clin Pract Endocrinol Metab 5:35–44. https://doi.org/10.1038/NCPENDMET1023
doi: 10.1038/NCPENDMET1023
pubmed: 19079272
Trimboli P, Giovanella L, Crescenzi A et al (2014) Medullary thyroid cancer diagnosis: an appraisal. Head Neck 36:1216–1223. https://doi.org/10.1002/HED.23449
doi: 10.1002/HED.23449
pubmed: 23955938
Kloos RT, Eng C, Evans DB et al (2009) Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid 19:565–612. https://doi.org/10.1089/THY.2008.0403
doi: 10.1089/THY.2008.0403
pubmed: 19469690
Trimboli P, Seregni E, Treglia G et al (2015) Procalcitonin for detecting medullary thyroid carcinoma: a systematic review. Endocr Relat Cancer 22:R157–R164. https://doi.org/10.1530/ERC-15-0156
doi: 10.1530/ERC-15-0156
pubmed: 25934688
Toledo SPA, Lourenço DM, Santos MA et al (2009) Hypercalcitoninemia is not pathognomonic of medullary thyroid carcinoma. Clinics 64:699–706. https://doi.org/10.1590/S1807-59322009000700015
doi: 10.1590/S1807-59322009000700015
pubmed: 19606248
pmcid: 2710445
Giannetta E, Guarnotta V, Altieri B et al (2020) Endocrine tumours: calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: the two-faced Janus. Eur J Endocrinol 183:R197–R215. https://doi.org/10.1530/EJE-20-0506
doi: 10.1530/EJE-20-0506
pubmed: 33112280
Franchimont P, Heynen G (1976) Parathormone and calcitonin radioimmunoassay in various medical and osteoarticular disorders. J Nuclear Med Book Reviews, Philadelphia, Lippincott, pp 134
Erdogan MF, Gursoy A, Kulaksizoglu M (2006) Long-term effects of elevated gastrin levels on calcitonin secretion. J Endocrinol Invest 29:771–775. https://doi.org/10.1007/BF03347369
doi: 10.1007/BF03347369
pubmed: 17114906
Becker KL, Silva OL, Cyrus J et al (1980) Hypercalcitonemia in pernicious anemia. Experientia 36:1330–1331. https://doi.org/10.1007/BF01969618
doi: 10.1007/BF01969618
pubmed: 7449924
Brandsborg M, Nielsen HE, Brandsborg O et al (1980) The role of serum gastrin in the secretion of calcitonin: studies in patients with pernicious anaemia and in healthy subjects. Scand J Gastroenterol 15:23–28. https://doi.org/10.3109/00365528009181426
doi: 10.3109/00365528009181426
pubmed: 7367817
Fahrenkrug J, De de Muckadell OB, Rehfeld JF (1977) Serum calcitonin in hypergastrinaemia due to achlorhydria. Acta Endocrinol 86:140–145. https://doi.org/10.1530/ACTA.0.0860140
doi: 10.1530/ACTA.0.0860140
Lamers CBH, Hackeng WHL, Thien T, Van Tongeren JHM (1980) Serum concentrations of immunoreactive calcitonin in patients with hypergastrinaemia. Digestion 20:379–382. https://doi.org/10.1159/000198477
doi: 10.1159/000198477
pubmed: 6105986
Rehfeld JF (2008) The art of measuring gastrin in plasma: a dwindling diagnostic discipline? Scand J Clin Lab Invest 68:353–361. https://doi.org/10.1080/00365510701771831
doi: 10.1080/00365510701771831
pubmed: 19172694
Said SI, Zfass AM (1978) Gastrointestinal hormones. Dis Mon 24:1–40. https://doi.org/10.1016/S0011-5029(78)80007-8
doi: 10.1016/S0011-5029(78)80007-8
pubmed: 95663
Karanikas G, Moameni A, Poetzi C et al (2004) Frequency and relevance of elevated calcitonin levels in patients with neoplastic and nonneoplastic thyroid disease and in healthy subjects. J Clin Endocrinol Metab 89:515–519. https://doi.org/10.1210/jc.2003-030709
doi: 10.1210/jc.2003-030709
pubmed: 14764755
Libbey NP, Nowakowski KJ, Tucci JR (1989) C-cell hyperplasia of the thyroid in a patient with goitrous hypothyroidism and Hashimoto’s thyroiditis. Am J Surg Pathol 13:71–77. https://doi.org/10.1097/00000478-198901000-00011
doi: 10.1097/00000478-198901000-00011
pubmed: 2909199
Guyetant S, Wion-Barbot N, Rousselet MC et al (1994) C-cell hyperplasia associated with chronic lymphocytic thyroiditis: a retrospective quantitative study of 112 cases. Hum Pathol 25:514–521. https://doi.org/10.1016/0046-8177(94)90124-4
doi: 10.1016/0046-8177(94)90124-4
pubmed: 8200646
Lima MA, Santos BM, Borges MF (1998) Quantitative analysis of C cells in Hashimoto’s thyroiditis. Thyroid 8:505–509. https://doi.org/10.1089/THY.1998.8.505
doi: 10.1089/THY.1998.8.505
pubmed: 9669288
Poppe K, Verbruggen LA, Velkeniers B et al (1999) Calcitonin reserve in different stages of atrophic autoimmune thyroiditis. Thyroid 9:1211–1214. https://doi.org/10.1089/THY.1999.9.1211
doi: 10.1089/THY.1999.9.1211
pubmed: 10646660
Borges MF, Abelin NMA, Menezes FOM et al (1998) Calcitonin deficiency in early stages of chronic autoimmune thyroiditis. Clin Endocrinol (Oxf) 49:69–75. https://doi.org/10.1046/J.1365-2265.1998.00478.X
doi: 10.1046/J.1365-2265.1998.00478.X
pubmed: 9797849
Body JJ, Demeester-Mirkine N, Borkowski A et al (1986) Calcitonin deficiency in primary hypothyroidism. J Clin Endocrinol Metab 62:700–703. https://doi.org/10.1210/JCEM-62-4-700
doi: 10.1210/JCEM-62-4-700
pubmed: 3949951