Thyroid Cancer Biomarkers: From Thyroglobulin and Calcitonin Harmonization Challenges to Emerging Diagnostics
This critical review examines the current state of thyroglobulin and calcitonin measurement for differentiated and medullary thyroid cancer monitoring, highlighting poor inter-assay harmonization and the clinical risks of switching platforms during follow-up. Emerging approaches including procalcitonin for medullary thyroid cancer and thyroglobulin doubling time show promise for improving clinical decision-making. The review underscores the essential role of lab-clinician collaboration in translating assay limitations into appropriate interpretation criteria.
The original study
Evolution of thyroid cancer biomarkers: from laboratory test to patients' clinical management.
- Authors
- Garo ML, Campennì A, Petranovic-Ovcaricek P, D'Aurizio F, Giovanella L
- Journal
- Clinical chemistry and laboratory medicine
- Type
- Journal Article, Review
- PMID
- 36370420
Original abstract
Over the past three decades, laboratory medicine has significantly evolved thanks to technological advances made possible by new materials and evidence. Clinicians' ongoing requests for powerful, rapid, and minimally invasive tests has led manufacturers to develop rapid, accurate, and sensitive tests that can increase diagnostic accuracy and improve follow-up, bringing laboratory medicine ever closer to personalized medicine. The aim of this study was to critically review the main problems of the current Tg and CT biomarkers for the diagnosis/monitoring of DTC and MTC, respectively, and to identify the advantages and challenges of using the new laboratory biomarkers in the clinical management of patients with differentiated and medullary thyroid cancer. Insufficient harmonization of Tg and CT assays and lack of interchangeability of laboratory results and cutoff values pose challenges for comparability and standardization of procedures and methods. New diagnostic and monitoring approaches such as PCT or the Tg doubling time have proven to be effective. Close collaboration between clinicians and laboratory specialists remains essential to translate the advantages and limitations of current assays into appropriate clinical interpretation criteria. Over the years, the journal Clinical Chemistry and Laboratory Medicine (CCLM) has taken many steps to develop advanced research and technology in the diagnosis and monitoring of tumor cancer and to help clinicians translate it into clinical practice.