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Many authors recommend the measurement of serum calcitonin (Ctn) to screen forsporadic medullary thyroid carcinoma (MTC) in patients with thyroid nodules. Inthis situation, procalcitonin (pro-Ctn) would have greater utility in patientswith hypercalcitoninemia&lt;100 pg/ml. The aim of thisstudy was to evaluate the utility of pro-Ctn in patients with thyroid nodulesand without a suspicion of familial MTC or type 2 multiple endocrine neoplasiawho had mild or moderate hypercalcitoninemia without an apparent cause.Consecutive patients with nodular thyroid disease assessed routinely by Ctnmeasurement were selected. Sixty patients with basalCtn&gt;10 pg/ml but&lt;100 pg/ml wereincluded. Nine patients (15%) had MTC, with cytology being diagnostic inonly four. Among the 51 patients without MTC, pro-Ctnwas&lt;0.1 ng/ml in 46 (90.2%). All patients withMTC had pro-Ctn&gt;0.1 ng/ml. Basal Ctnwas&gt;24.6 pg/ml in all patients with MTC and in 42patients (82.3%) without MTC. It is noteworthy that among patients withbasal Ctn&gt;24.6 pg/ml (n=18)pro-Ctn&gt;0.1 ng/ml identified all patients with MTC and64.2% of subjects with these pro-Ctn concentrations had this tumor. Inconclusion, we did not find superiority of pro-Ctn over Ctn for the diagnosis ofsporadic MTC in patients with nodular disease and mild or moderatehypercalcitoninemia. However, in the case of patients with hypercalcitoninemiain the gray zone, pro-Ctn has an excellent negative predictive value while thedata regarding its positive predictive value are not uniform.

Diagnostic Utility of Procalcitonin for Sporadic Medullary Thyroid Carcinoma in Patients with Nodular Disease and Mild or Moderate Hypercalcitoninemia