J Clin Endocrinol Metab. 2021 Aug 12:dgab564. doi: 10.1210/clinem/dgab564. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aimed to determine the procalcitonin (ProCT) diagnostic accuracy in prediction and treatment monitoring of medullary thyroid carcinoma (MTC).
DATA SOURCES: Electronic databases were searched for observational studies published until May 2021 without language or time restrictions.
STUDY SELECTION: Studies comparing ProCT and calcitonin accuracy were included. After removing duplicates and exclusion of not-eligible articles, relevant articles were screened independently by two reviewers. Eleven studies (4.5% of the identified studies) met the selection criteria.
DATA EXTRACTION: Two reviewers independently extracted data and assessed data quality and validity through QUADAS-2.
DATA SYNTHESIS: A meta-analysis was performed on sufficiently clinically and statistically homogeneous eleven studies (n = 5817 patients, 335 MTC patients). HSROC and bivariate methods were applied. Serum ProCT was found to be a highly accurate test for MTC diagnosis and monitoring. The pooled sensitivity, specificity, positive and negative likelihood ratios, AUC, and positive and negative predictive values for ProCT were 0.90 (95%CI: 0.71-0.97), 1.00 (95%CI: 0.85-1.00), 288 (95%CI: 5.6-14929.3), 0.10 (95%CI: 0.03-0.33), 0.97 (95%CI: 0.95-0.98), 99% and 2%.
CONCLUSIONS: The high accuracy, compounded with favorable analytical characteristics, give ProCT great potential to replace calcitonin as a new standard of care in the management of MTC.
PMID:34382653 | DOI:10.1210/clinem/dgab564
