SKRINING MEDULARNOG KARCINOMA U OSOBA S ČVOROVIMA U ŠTITASTOJ ŽLEZDI
Sažetak
Uvod/cilj: Medularni karcinom štitaste žlezde (engl. Medullary tyroid cancer - MTC) je retka neuroendokrina neoplazma, koja nastaje iz parafolikularnih C ćelija, koje luče kalcitonin. Kalcitonin predstavlja osetljiv tumorski marker MTC, imajući u vidu da najveći broj obolelih ima povišene vrednosti istog. Ipak, ne postoji jedinstveni stav o upotrebi kalcitonina kao skrining testa za rano otkrivanje MTC kod osoba s čvorovima u štitastoj žlezdi. Cilj istraživanja je bio da se analizira mogućnost uvođenja kalcitonina kao skrining testa za rano otkrivanje MTC kroz prikaz jednog slučaja.
Prikaz bolesnika: U radu je prikazana pacijentkinja starosti 56 godina kojoj je prilikom sistematskog pregleda u desnom režnju štitne žlezde ustanovljeno prisustvo nodusa dijametra 10 x 8 mm i 5 x 4 mm. Laboratorijskom analizom utvrđene su blago povišene vrednosti kalcitonina (7,8 pg/mL, referentna vrednosti < 4,8 pg/mL). Test stimulacije kalcijumom bio je u referentnom rasponu, a vrednosti karcino-embrionalnog antigena uredne. Citološki pregled uzoraka aspiracione punkcije tankom iglom je odgovarao kategoriji T2 po Bethesda klasifikaciji (hronični limfocitni tireoiditis tipa Hashimoto). Na kontrolnom pregledu, sprovdenom posle 6 meseci, vrednosti kalcitonina nisu se značajno razlikovale u odnosu na prvobitne.
Zaključak: Kod prikazane pacijentkinje diskretno povišena koncentracija kalcitonina u serumu nije podrazumevalo prisustvo MTC. Potrebna su dalja randomizirana klinička istraživanja kako bi se otklonile nesuglasice i utvrdile jedinstvene smernice za uvođenje kalcitonina kao skrining testa za MTC kod osoba sa čvorovima u štitastoj žlezdi.
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