CALCITONIN HETEROGENEITY IN LUNG CANCER AND MEDULLARY THYROID CANCER

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Abstract
Increased serum calcitonin in patients with medullary thyroid cancer and bronchogenic carcinoma was investigated to determine whether these conditions can be differentiated immunochemically. Endogenous fractions of immunoreactive calcitonin were separated by gel filtration and radioimmunoassayed with calcitonin antibodies having different region specificities. The pattern of serum heterogeneity of patients with medullary thyroid cancer was characterized by the presence of at least 7 different fractions of immunoreactive calcitonin, ranging from fraction I (.gtoreq. 30,000 MW) to fraction V (.apprx. 2500 MW). Most patients with bronchogenic cancer had a predominance of high MW fractions (i.e., fractions I and II A). Following in vitro incubation of the serum, the typical large MW pattern of bronchogenic cancer serum was converted to the more diffuse pattern seen in the serum of medullary thyroid cancer. Pre-operatively, the hypercalcitonemia serum of medullary thyroid cancer patients were differentiated from that of bronchogenic cancer patients by determination of the ratio of calcitonin as radioimmunoassayed with midportion vs. carboxyl terminal antibody.

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