Measuring calcitonin in washout of the needle in patients undergoing fine needle aspiration with suspicious medullary thyroid cancer
Article first published online: 11 MAY 2011
Copyright © 2011 Wiley-Liss, Inc.
Volume 40, Issue 5, pages 394–398, May 2012
How to Cite
Trimboli, P., Rossi, F., Baldelli, R., Laurenti, O., Nigri, G., Ventura, C., Appetecchia, M., Attanasio, D., Romanelli, F., Guidobaldi, L., Guarino, M., Crescenzi, A. and Valabrega, S. (2012), Measuring calcitonin in washout of the needle in patients undergoing fine needle aspiration with suspicious medullary thyroid cancer. Diagn. Cytopathol., 40: 394–398. doi: 10.1002/dc.21731
- Issue published online: 17 APR 2012
- Article first published online: 11 MAY 2011
- Manuscript Accepted: 6 APR 2011
- Manuscript Received: 11 FEB 2011
- medullary thyroid carcinoma;
- washout measurement;
- fine needle aspiration
Calcitonin measurement in washout of the needle after aspiration (WO-Ct) has been rarely evaluated. Here we analyzed the role of WO-Ct in a series of subjects who underwent fine needle aspiration (FNA) with suspicious medullary thyroid cancer (MTC). Twenty-one patients referred following elevated serum calcitonin (S-Ct) or suspicious MTC by cytology. All patients underwent re-evaluation of S-Ct, FNA, and measurement of WO-Ct. S-Ct and WO-Ct were assessed by chemiluminescence assay (IMMULITE 2000, Diagnostic Products Corporation, USA). S-Ct showed elevated value in six subjects (mean 368.8 ± 373.9 pg/ml), of which three cases were cytologically classified as Class 5. WO-Ct obtained in this group (304.0 ± 309.3 pg/ml) was no different from S-Ct. After surgery MTC was confirmed in all patients. In the other 15 patients MTC was excluded by cytology or histology. Two subjects had moderately skewed S-Ct with nonmedullary histology. In the remaining 13 patients S-Ct resulted normal (6.2 ± 5.6 pg/ml) and WO-Ct low (2.9 ± 2.2 pg/ml). Significant (two-tailed P < 0.05, r2 = 0.27, 95% confidence interval = 0.017–0.81) correlation was found between S-Ct and WO-Ct in nonmedullary patients but not in MTC patients. This study showed that WO-Ct can play a role in diagnosing primary and metastatic MTC. The procedure is easy, cost effective, and should be used in patients undergoing FNA with elevated S-Ct. Further studies and guidelines for the method are needed to use this technique in clinical routine. Until this any institute should use itself cut-off. Diagn. Cytopathol. 2011. © 2011 Wiley-Liss, Inc.