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. 2018 Sep 17;47(1):55.
doi: 10.1186/s40463-018-0303-x.

Carcinoembryonic antigen levels correlated with advanced disease in medullary thyroid cancer

Sena Turkdogan  1 , Véronique-Isabelle Forest  2 , Michael P Hier  2 , Michael Tamilia  3 , Anca Florea  4 , Richard J Payne  5   6
Affiliations

Carcinoembryonic antigen levels correlated with advanced disease in medullary thyroid cancer

Sena Turkdogan et al. J Otolaryngol Head Neck Surg. .

Abstract

Background: Medullary thyroid cancer (MTC) cells are capable of secreting various tumor markers including calcitonin and carcinoembyronic antigen (CEA). The purpose of this study is to determine whether abnormal CEA levels may be used as a tumor marker to predict the severity of disease in MTC.

Methods: A retrospective analysis was completed for 33 patients with MTC who had preoperative serum CEA levels. Univariate and multivariate analyses were used to quantify the relationship between serum CEA levels and tumor stage and prognosis.

Results: On multivariate analysis, elevated preoperative CEA levels were significantly associated with the size and stage of tumor, distant metastasis, decreased biochemical cure, and mortality. There was a significant association between tumor size greater than 37 mm and elevated CEA levels (> 271 ng/ml). There was also a positive correlation with increased cancer stage (> 377 ng/ml), distant metastasis (> 405 ng/ml), and contralateral compartment location of lymph node metastasis (> 162 ng/ml). When pre-operative CEA levels are > 500 ng/ml, patient mortality was 67%.

Conclusion: In this study, both pre-operative calcitonin and CEA levels were significantly correlated with the extent of disease in MTC. While calcitonin has a linear relationship with disease progression, abnormal CEA levels were a better indicator of advanced disease. CEA levels > 271 ng/ml are significant for advanced tumor size and staging, metastasis to the central compartment, and decreased chance of biochemical cure. CEA levels greater than 500 ng/ml are associated with significant patient mortality.

Keywords: Advanced disease; Calcitonin; Carcinoembryonic antigen; Medullary thyroid carcinoma; Mortality; Tumor marker.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics Approval and consent to publication was granted by the West Central Montreal Health (WCMH) Research Ethics Committee.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Relationship between pre-operative carcinoembryonic antigen levels and the size of the tumor (mm)
Fig. 2
Fig. 2
Relationship between pre-operative carcinoembryonic antigen levels and the stage of tumor
Fig. 3
Fig. 3
Relationship between pre-operative carcinoembryonic antigen levels and the number of metastatic lymph nodes
Fig. 4
Fig. 4
Relationship between pre-operative calcitonin levels and the size of the tumor (mm)
See this image and copyright information in PMC

References

    1. Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB. Cancer Incidence in Five Continents Vol. VIII. France: IARC Scientific Publication No. 155. 2002;155:53.
    1. Wells SA, Jr, Asa SL, Dralle H, et al. American Thyroid Association guidelines task force on medullary thyroid carcinoma. Thyroid. 2015;25(6):567. doi: 10.1089/thy.2014.0335. - DOI - PMC - PubMed
    1. Bae YJ, Schaab M, Kratzsch J. Calcitonin as Biomarker for the Medullary Thyroid Carcinoma. Recent Results Cancer Res. 2015;204:117–137. doi: 10.1007/978-3-319-22542-5_5. - DOI - PubMed
    1. Cheung K, Roman SA, Wang TS, Walker HD, Sosa JA. Calcitonin measurement in the evaluation of thyroid nodules in the United States: a cost-effectiveness and decision analysis. J Clin Endocrinol Metab. 2008;93:62173–62180. - PubMed
    1. Costante G, Durante C, Francis Z, Schlumberger M, Filetti S. Determination of calcitonin levels in C-cell disease: clinical interest and potential pitfalls. Nat Clin Pract Endocrinol Metab. 2009;5:35–44. doi: 10.1038/ncpendmet1023. - DOI - PubMed

Supplementary concepts