Macrocalcitonin Is a Novel Pitfall in the Routine of Serum Calcitonin Immunoassay

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dc.citation.issue2
dc.citation.volume101
dc.contributor.authorAlves, Thalita G. [UNIFESP]
dc.contributor.authorKasamatsu, Teresa S. [UNIFESP]
dc.contributor.authorYang, Ji H. [UNIFESP]
dc.contributor.authorMeneghetti, Maria Cecilia Z. [UNIFESP]
dc.contributor.authorMendes, Aline [UNIFESP]
dc.contributor.authorKunii, Ilda S. [UNIFESP]
dc.contributor.authorLindsey, Susan C. [UNIFESP]
dc.contributor.authorCamacho, Cleber P. [UNIFESP]
dc.contributor.authorDias da Silva, Magnus R. [UNIFESP]
dc.contributor.authorMaciel, Rui M. B. [UNIFESP]
dc.contributor.authorVieira, Jose Gilberto H. [UNIFESP]
dc.contributor.authorMartins, Joao Roberto M. [UNIFESP]
dc.coverageWashington
dc.date.accessioned2020-08-21T17:00:26Z
dc.date.available2020-08-21T17:00:26Z
dc.date.issued2016
dc.description.abstractContext: Calcitonin (CT) is a sensitive marker of medullary thyroid carcinoma (MTC) and is used for primary diagnosis and follow-up after thyroidectomy. However, persistently elevated CT is observed even after complete surgical removal without evidence of a recurrent or persistent tumor. Objective: To investigate the presence of assay interference in the serum CT of MTC patients who are apparently without a structural disease. Patients and Methods: We studied three index MTC cases for CT assay interference and 14 patients with metastatic MTC. The CT level was measured using an immunofluorometric assay. Screening for assay interference was performed by determination of CT levels before and after serum treatment with polyethylene glycol. Additionally, samples were analyzed by chromatography on ultra-performance liquid chromatography and protein A-Sepharose. Results: Patients with biochemical and structural disease showed CT mean recovery of 84.1% after polyethylene glycol treatment, whereas patients suspected of interference showed recovery from 2-7%. The elution profile on UPLC showed that the immunometric CT from these three patients behaved like a high molecular mass aggregate (>300 kDa). Additionally, when these samples were applied to the protein A-Sepharose, CT immunoreactivity was retained on the column and was only released after lowering the pH. Conclusions: For the first time, our results show the presence of a novel pitfall in the CT immunoassay: "macrocalcitonin." Its etiology, frequency, and meaning remain to be defined, but its recognition is of interest and can help clinicians avoid unnecessary diagnostic investigations and treatment during the follow-up of MTC.en
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Div Endocrinol, Dept Med,Thyroid Dis Ctr, BR-04039032 Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Div Endocrinol, Dept Med,Lab Mol & Translat Endocrinol, BR-04039032 Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Dept Biochem, Div Mol Biol, BR-04044020 Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Div Endocrinol, Dept Med,Thyroid Dis Ctr, BR-04039032 Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Div Endocrinol, Dept Med,Lab Mol & Translat Endocrinol, BR-04039032 Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Dept Biochem, Div Mol Biol, BR-04044020 Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipSao Paulo State Research Foundation-FAPESP
dc.description.sponsorshipFAPESP
dc.description.sponsorshipFederal Agency of Support and Evaluation of Postgraduate Education (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior)
dc.description.sponsorshipNational Council for Scientific and Technological Development
dc.description.sponsorshipIDFAPESP: 2006/60402-1
dc.description.sponsorshipIDFAPESP: 2010/51547-1
dc.description.sponsorshipIDFAPESP: 2010/19478
dc.format.extent653-658
dc.identifierhttp://dx.doi.org/10.1210/jc.2015-3137
dc.identifier.citationJournal Of Clinical Endocrinology & Metabolism. Washington, v. 101, n. 2, p. 653-658, 2016.
dc.identifier.doi10.1210/jc.2015-3137
dc.identifier.fileWOS000378642700035.pdf
dc.identifier.issn0021-972X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57993
dc.identifier.wosWOS:000378642700035
dc.language.isoeng
dc.publisherEndocrine Soc
dc.relation.ispartofJournal Of Clinical Endocrinology & Metabolism
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleMacrocalcitonin Is a Novel Pitfall in the Routine of Serum Calcitonin Immunoassayen
dc.typeinfo:eu-repo/semantics/article
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