Calcitonin | Laboratory research

Calcitonin Is a polypeptide hormone secreted by parathyroid C cells of the thyroid gland (they are also called calcitonin cells). The main action of calcitonin is to stop bone resorption (digestion). It achieves this effect by regulating the number and activity of osteoclasts.

Calcitonin is produced in response to an increase in serum calcium, thus regulating serum calcium levels and variability in concentration. However, its role in calcium regulation is negligible compared to parathyroid hormone. Therefore, it is rarely used in combination with PTH and vitamin D3 to study disorders of calcium homeostasis.

Calcitonin is a tumor-specific and sensitive marker. Malignant tumors arising from thyroid cells (medullary carcinoma of the thyroid gland) usually secrete elevated amounts of calcitonin. Medullary carcinoma of the thyroid gland is a rare malignant tumor, its development may be related to genetic-familial predisposition, or it may be the result of a spontaneous mutation. The main marker of its diagnostics and monitoring is calcitonin.

Blood serum calcitonin concentrations are high in infants, decrease rapidly in infants, and are then relatively stable. In general, serum calcitonin concentrations are higher in men. Calcitonin levels may be elevated in patients with chronic renal failure as well as in other conditions such as hyperparathyroidism, leukemia, myeloproliferative disorders, Zollinger-Ellison syndrome, Philoebus, Auiliburo syndromes, Philo .

When to take a test for calcitonin?

• Diagnosis of clinically pronounced thyroid cancer in patients with "cold" nodules or suspicious cytological results, as well as in patients with thyroid cancer but with unreliable histology (eg anaplastic cancer);
• Family screening in cases of hereditary medullary carcinoma of the thyroid gland;
• Relatives of patients with hereditary multiple endocrine neoplasia syndrome type 2 (MEN2 - in the English literature).
• Calcitonin is measured after stimulation of pentagastrin.
• In 25% of cases, thyroid carcinoma, type 2, is part of MEN syndrome, with autosomal dominant transmission.
• Patients who have bilateral / unilateral and / or familial pheochromocytoma. 2% of MEN50 patients develop pheochromocytoma, which may precede the clinical manifestations of medullary thyroid carcinoma.
• Postoperative monitoring of thyroid medullary carcinoma surgery. The concentration of calcitonin is related to tumor mass. Doubling the concentration is associated with tumor recurrence;
• Observation in patients with neuroendocrine tumors: carcinoid, insulinoma, small cell lung cancer. In them, calcitonin secretion may be part of paraneoplastic syndrome.
• Complex assessment of calcium metabolism in combination with PTH and vitamin D3.

Calcitonin testing is recommended for thyroid cancer, which initially does not usually cause any clinical manifestations. When thyroid cancer grows, it can cause the following symptoms:

• A tumor that is felt in the neck;
• Sound changes, including choking;
• Difficulty swallowing;
• Neck and throat pain;
• Enlarged lymph nodes in the neck

How to prepare for the test?

No special preparation is required for the test.

Research material

Venous blood

Possible interpretation of the results

Low levels of calcitonin Means that symptoms are less likely due to C-cell hyperplasia of the thyroid gland or medullary carcinoma of the thyroid gland.

Increased concentration of calcitonin Means that excessive amounts of this hormone are produced. Significantly elevated levels of calcitonin are a strong indicator of C-cell hyperplasia or thyroid cancer. However, other procedures such as thyroid biopsy, scan, and ultrasound are needed to make an accurate diagnostics.

Calcitonin levels usually rise in newborns. This rate is often elevated in leukemic and myeloproliferative diseases. Calcitonin can also be produced by lung tumors. Elevated calcitonin is also characterized by hyperparathyroidism, hypergastrinemia, renal failure, and chronic inflammatory diseases.