Urine Calcitonin as a Test for Medullary Thyroid Cancer

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Abstract
Although the radioimmunoassay of serum calcitonin (CT) facilitated the diagnosis of medullary thyroid cancer (MTC) patients are encountered whose basal serum levels of CT are normal or nearly normal. In such cases i.v. stimulation tests such as Ca or pentagastrin were utilized to obtain a diagnostic increase in serum CT. Immunoreactive CT was found in the urine of man and used for the diagnosis and study of patients at risk for MTC or other hypercalcitonemic diseases. Using basal urine CT alone, 73% of patients at risk for MTC were separated into clearly normal or abnormal groups. For the remaining 27% a stimulation test with subsequent determination of urine CT was required. The radioimmunoassay of urine CT is a simple, reliable, accurate test for the screening diagnosis of MTC. A protocol for the screening workup of a patient at risk for MTC is given.