Journal of Clinical Endocrinology & Metabolism, Vol 71, 1064-1067, Copyright © 1990 by Endocrine Society

ARTICLES

Diagnosis of medullary carcinoma of the thyroid (MCT) by calcitonin assay using monoclonal antibodies: criteria for the pentagastrin stimulation test in hereditary MCT

D Guilloteau, R Perdrisot, C Calmettes, JL Baulieu, P Lecomte, G Kaphan, G Milhaud, JC Besnard, P Jallet and JC Bigorgne
Centre Hospitalier Universitaire, Tours, France.

A new calcitonin (CT) immunoradiometric assay, using anti-11-7 and anti- 24-32 CT fragment monoclonal antibodies was evaluated and compared to classical RIA. The sensitivity was 2.5 ng/L, the normal basal level (n = 83) was lower than 10 ng/L, the response to pentagastrin stimulation in control subjects was absent in nine and between 10-30 ng/L in nine others. (mean, 15.4). In patients with renal failure the basal level was increased between 10-52 ng/L. In patients with medullary thyroid carcinoma (MTC; n = 28), the basal level was between 189-28,900 ng/L. A pentagastrin test was performed as screening for familial MTC in eight patients with confirmed MTC at subsequent surgery; the calcitonin peak was equal or greater than 38 ng/L. Large differences exist between CT levels measured by RIA and immunoradiometric assay. The latter method provides a greater sensitivity to pentagastrin test and allows a better identification of microcarcinoma in hereditary cases of MTC.

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