{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:25:02Z","timestamp":1791444302789,"version":"4.3.3"},"reference-count":84,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Endocrinology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>Calcitonin (CT) is most effectively produced by the parafollicular cells of the thyroid gland. It acts through the calcitonin receptor (CTR), a seven-transmembrane class II G-protein-coupled receptor linked to multiple signal transduction pathways with its main secretagogues being calcium and gastrin. It is clinically used mostly in the diagnosis and follow-up of medullary thyroid carcinoma (MTC). Hypercalcitoninemia can be attributed to primary (e.g. CT-secreting tumor) or secondary (e.g. due to hypercalcemia) overproduction, underexcretion (e.g. renal insufficiency), drug reaction (e.g. \u03b2-blockers), or false-positive results. In clinical practice, elevated basal calcitonin (bCT) is indicative, but not pathognomonic, of MTC. Current literature leans toward an age as well as gender-specific cutoff approach. bCT &gt;100\u2009pg\/ml has up to 100% positive prognostic value (PPV) for MTC, whereas bCT between 8 and 100\u2009pg\/ml for adult males and 6 and 80\u2009pg\/ml for adult females should be possibly further investigated with stimulation calcitonin (sCT) tests. Calcium is showing similar efficacy with pentagastrin (Pg) sCT; however, the real value of these provocative tests has been disputed given the availability of new, highly sensitive CT immunoassays. Anyhow, evidence concludes that sCT &lt;2 times bCT may not be suggestive of MTC, in which case, thyroid in addition to whole body workup based on clinical evaluation is further warranted. Moreover, measurement of basal and stimulated procalcitonin has been proposed as an emerging concept in this clinical scenario. Measuring bCT levels in patients with thyroid nodules as a screening tool for MTC remains another controversial topic. It has been well established, though, that bCT levels raise the sensitivity of FNAB (Fine Needle Aspiration Biopsy) and correlate with disease progression both pre- and postoperatively in this situation. There have been numerous reports about extrathyroidal neoplasms that express CT. Pancreatic, laryngeal, and lung neuroendocrine neoplasms (NENs) are most frequently associated with hypercalcitoninemia, but CT production has also been described in various other neoplasms such as duodenal, esophageal, cutaneous, and paranasal NENs as well as prostate, colon, breast, and lung non-NENs. This review outlines the current biosynthetic and physiology concepts about CT and presents up-to-date information regarding the differential diagnosis of its elevation in various clinical situations.<\/jats:p>","DOI":"10.1177\/20420188221099344","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T04:24:34Z","timestamp":1653107074000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":44,"title":["Calcitonin: current concepts and differential diagnosis"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4774-777X","authenticated-orcid":false,"given":"Andreas","family":"Kiriakopoulos","sequence":"first","affiliation":[{"name":"5th Surgical Clinic, Department of Surgery, \u2018Evgenidion Hospital\u2019, National and Kapodistrian University of Athens Medical School, Papadiamantopoulou 20 Str, PO: 11528, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6192-6371","authenticated-orcid":false,"given":"Periklis","family":"Giannakis","sequence":"additional","affiliation":[{"name":"5th Surgical Clinic, Department of Surgery, \u2018Evgenidion Hospital\u2019, National and Kapodistrian University of Athens Medical School, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Menenakos","sequence":"additional","affiliation":[{"name":"5th Surgical Clinic, Department of Surgery, \u2018Evgenidion Hospital\u2019, National and Kapodistrian University of Athens Medical School, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,21]]},"reference":[{"key":"bibr1-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1242\/dev.126581"},{"key":"bibr2-20420188221099344","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.617400"},{"key":"bibr3-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-20-0506"},{"key":"bibr4-20420188221099344","volume-title":"Calcitonin","author":"McLaughlin MB","year":"2021"},{"key":"bibr5-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1615\/CritRevNeurobiol.v11.i2-3.40"},{"key":"bibr6-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-9781(96)00169-6"},{"key":"bibr7-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/0014-5793(84)80839-X"},{"key":"bibr8-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2014-202807"},{"key":"bibr9-20420188221099344","first-page":"S57","volume":"49","author":"Maruna P","year":"2000","journal-title":"Physiol Res"},{"key":"bibr10-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.2009.00433.x"},{"key":"bibr11-20420188221099344","first-page":"117","volume":"4","author":"Masi L","year":"2007","journal-title":"Clin Cases Miner Bone Metab"},{"key":"bibr12-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2613.2000.00176.x"},{"key":"bibr13-20420188221099344","first-page":"19808","volume":"273","author":"Chen Y","year":"1998","journal-title":"J Biol Chem"},{"key":"bibr14-20420188221099344","first-page":"474","volume-title":"Principles and practice of endocrinology and metabolism","author":"Becker L","year":"1995","edition":"2"},{"key":"bibr15-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/S0083-6729(08)60682-2"},{"key":"bibr16-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1007\/BF00354778"},{"key":"bibr17-20420188221099344","unstructured":"Rosai J, Carangiu ML, DeLellis RA. Tumours of the thyroid gland. In: Rosai J, Carcangiu ML and DeLellis R (eds). Atlas of tumour pathology, third series. Washington, DC: Armed Forces Institute of Pathology, 1992, pp. 247\u2013258."},{"key":"bibr18-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0335"},{"key":"bibr19-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-2368"},{"key":"bibr20-20420188221099344","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12102894"},{"key":"bibr21-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6075"},{"key":"bibr22-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2013.03.443"},{"key":"bibr23-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/9267972"},{"key":"bibr24-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23375"},{"key":"bibr25-20420188221099344","doi-asserted-by":"publisher","DOI":"10.3906\/sag-2105-280"},{"key":"bibr26-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3095"},{"key":"bibr27-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/j.etp.2017.05.003"},{"key":"bibr28-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0236"},{"key":"bibr29-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1998.00392.x"},{"key":"bibr30-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2001.01339.x"},{"key":"bibr31-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6600930"},{"key":"bibr32-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1984)54:4<657::AID-CNCR2820540412>3.0.CO;2-V"},{"key":"bibr33-20420188221099344","doi-asserted-by":"publisher","DOI":"10.4065\/83.9.1032"},{"key":"bibr34-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-011-1676-0"},{"key":"bibr35-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1007\/BF02553290"},{"key":"bibr36-20420188221099344","first-page":"1445","volume":"77","author":"Bilezikian JP","year":"1993","journal-title":"J Clin Endocrinol Metab"},{"key":"bibr37-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-57-4-749"},{"key":"bibr38-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0361"},{"key":"bibr39-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.85.5.6601"},{"key":"bibr40-20420188221099344","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2018.030710"},{"key":"bibr41-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-39-1-108"},{"key":"bibr42-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-2403"},{"key":"bibr43-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1186\/1756-6614-6-S1-S2"},{"key":"bibr44-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1159\/000491040"},{"key":"bibr45-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-63-3-785"},{"key":"bibr46-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.051210"},{"key":"bibr47-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-09-3534"},{"key":"bibr48-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2018.04.009"},{"key":"bibr49-20420188221099344","doi-asserted-by":"publisher","DOI":"10.5114\/ait.2019.88104"},{"key":"bibr50-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2020.09.001"},{"key":"bibr51-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(88)80262-4"},{"key":"bibr52-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/0046-8177(94)90124-4"},{"key":"bibr53-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1159\/000511080"},{"key":"bibr54-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-021-01685-3"},{"key":"bibr55-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0564"},{"key":"bibr56-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030550"},{"key":"bibr57-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-2735"},{"key":"bibr58-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.02158"},{"key":"bibr59-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.82.2.3737"},{"key":"bibr60-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1159\/000494834"},{"key":"bibr61-20420188221099344","volume":"3","author":"Verbeek HH","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr62-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1530\/EC-21-0030"},{"key":"bibr63-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-2496"},{"key":"bibr64-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.104878"},{"key":"bibr65-20420188221099344","doi-asserted-by":"publisher","DOI":"10.4158\/EP161208.GL"},{"key":"bibr66-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1159\/000180860"},{"key":"bibr67-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1320075"},{"key":"bibr68-20420188221099344","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-121-3-199408010-00012"},{"key":"bibr69-20420188221099344","first-page":"1717","volume-title":"Williams textbook of endocrinology","author":"Gagel RF","year":"2003","edition":"10"},{"key":"bibr70-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1590\/S1807-59322009000700015"},{"key":"bibr71-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-1590"},{"key":"bibr72-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-4088"},{"key":"bibr73-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0162"},{"key":"bibr74-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2019.0785"},{"key":"bibr75-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2010.151688"},{"key":"bibr76-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1111\/eci.12934"},{"key":"bibr77-20420188221099344","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.754565"},{"key":"bibr78-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2021-0428"},{"key":"bibr79-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0045(20000801)44:3<181::AID-PROS1>3.0.CO;2-L"},{"key":"bibr80-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-19-0333"},{"key":"bibr81-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3800105"},{"key":"bibr82-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-017-9505-4"},{"key":"bibr83-20420188221099344","doi-asserted-by":"publisher","DOI":"10.1054\/npep.1999.0012"},{"key":"bibr84-20420188221099344","unstructured":"National Center for Biotechnology Information. PubChem Compound Summary for CID 16220016, Calcitonin, 2022, https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/Calcitonin (accessed 16 February 2022)."}],"container-title":["Therapeutic Advances in Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20420188221099344","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20420188221099344","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20420188221099344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:36:02Z","timestamp":1777592162000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20420188221099344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":84,"alternative-id":["10.1177\/20420188221099344"],"URL":"https:\/\/doi.org\/10.1177\/20420188221099344","relation":{},"ISSN":["2042-0188","2042-0196"],"issn-type":[{"value":"2042-0188","type":"print"},{"value":"2042-0196","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"article-number":"20420188221099344"}}