Serum Carcinoembryonic Antigen as a Biomarker for Medullary Thyroid Cancer

김진영; 박현주; 최민선; 박준; 장혜원; 김태혁; 김선욱; 정재훈

doi:10.11106/ijt.2021.14.2.143

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자료유형: 학술저널

저자정보: 김진영 (Sungkyunkwan University School of Medicine) 박현주 (Sungkyunkwan University School of Medicine) 최민선 (Sungkyunkwan University School of Medicine) 박준 (Sungkyunkwan University School of Medicine) 장혜원 (Sungkyunkwan University School of Medicine) 김태혁 (성균관대학교) 김선욱 (성균관대학교) 정재훈 (성균관대학교)

저널정보: 대한갑상선학회 International Journal of Thyroidology International Journal of Thyroidology 제14권 제2호

발행연도: 2021.11

수록면: 143 - 151 (9page)

DOI: 10.11106/ijt.2021.14.2.143

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Background and Objectives: The lack of known elevated biomarkers in cancer surveillance is a challenge fordiagnostics. However, few studies have assessed the proportion of patients with medullary thyroid cancer (MTC)that presented with elevated serum carcinoembryonic antigen (CEA) level. Materials and Methods: This was aretrospective study of 115 patients treated for MTC at Samsung Medical Center between 1995 and 2017. Serumcalcitonin and CEA levels that were available at one of the following time points were included: (a) within 3months before the initial surgery, (b) when a structural recurrence was confined to the neck, or (c) when a distantmetastasis was identified during follow-up. Considering the high false-positive rate of serum CEA testing, 5 ng/mLwas selected as the cut-off threshold. Results: The sensitivity of CEA at the time of diagnosis was 54%, but itsignificantly increased with anatomical stage, from 20% in stage I to 88% in stage IV (p for trend ＜0.001). At the time of diagnosis, larger tumor size, more frequent gross extra-thyroidal extension, more frequent N1b,and a higher number of metastatic lymph nodes were significantly observed in CEA-positive patients comparedwith CEA-negative patients (p＜0.05). The sensitivity of CEA at the time of recurrence was 56% for localrecurrence and 80% for distant recurrence. Conclusion: The CEA value was associated with anatomical stage asa biomarker for MTC and could be used to predict poor prognosis. However, serum CEA testing plays a limitedrole in diagnosis and follow-up of MTC because it can show normal values even in advanced disease.

#Thyroid neoplasms #Biomarkers #Carcinoembryonic antigen

참고문헌 (30)

참고문헌 신청

Hazard JB / 1959 / Medullary(solid)carcinoma of the thyroid; a clinicopathologic entity / J Clin Endocrinol Metab 19(1):152~161

Kebebew E / 2000 / Medullary thyroid carcinoma : clinical characteristics, treatment, prognostic factors, and a comparison of staging systems / Cancer 88(5):1139~1148

Williams ED / 1966 / Histogenesis of medullary carcinoma of the thyroid / J Clin Pathol 19(2):114~118

de Groot JW / 2006 / Biochemical markers in the follow-up of medullary thyroid cancer / Thyroid 16(11):1163~1170

Saad MF / 1984 / Diagnostic and prognostic values of carcinoembryonic antigen in medullary carcinoma of the thyroid / J Clin Endocrinol Metab 58(5):889~894

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