{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:25:13Z","timestamp":1783571113123,"version":"3.55.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Medullary thyroid cancer (MTC) is capable of secreting several proteins, such as calcitonin (Ct), carcinoembryonic antigen (CEA), chromogranin and others. Recently, we observed an aggressive MTC with high levels of serum carbohydrate antigen 19.9 (Ca 19.9) and a rapid evolution to death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to evaluate whether high levels of serum Ca 19.9 could be a prognostic factor of death in patients with advanced MTC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>We measured Ca 19.9, CEA and Ct in 100 advanced structural recurrent\/persistent MTC patients and in 100 cured or biochemically affected MTC patients. Clinical and pathological data were also collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen percent of the patients with advanced MTC had high levels of Ca 19.9. The group with abnormal Ca 19.9 levels had significantly higher levels of CEA and Ct compared with the group with normal values of Ca 19.9 (<jats:italic>P<\/jats:italic>&lt;0.0001 for both Ct and CEA). At variance, all 100 patients in the MTC control group showed normal levels of Ca 19.9. Moreover, among the advanced cases, the Ca 19.9-positive group showed a higher mortality rate than the group with normal levels. A logistic regression analysis demonstrated that an elevated level of Ca 19.9 is a predictor of mortality (OR=3.78,<jats:italic>P<\/jats:italic>=0.04), independent from Ct doubling time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results demonstrated that an elevated value of serum Ca 19.9 appears to be a predictive factor of poor prognosis in advanced MTC patients and identifies those cases with a higher risk of mortality in the short term.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-15-0304","type":"journal-article","created":{"date-parts":[[2015,6,2]],"date-time":"2015-06-02T15:23:35Z","timestamp":1433258615000},"page":"297-304","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":34,"title":["Elevated level of serum carbohydrate antigen 19.9 as predictor of mortality in patients with advanced medullary thyroid cancer"],"prefix":"10.1093","volume":"173","author":[{"given":"Rossella","family":"Elisei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana","family":"Lorusso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Piaggi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liborio","family":"Torregrossa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pellegrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Molinaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Agate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Bottici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Pani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Cacciato Insilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Casella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Ciampi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Tognetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Materazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvio","family":"Basolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Romei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2015080418004370000_173.3.297.1","doi-asserted-by":"crossref","unstructured":"Marsh DJ Learoyd DL Robinson BG . Medullary thyroid carcinoma: recent advances and management update. Thyroid 1995 5 407\u2013424. (doi:10.1089\/thy.1995.5.407).","DOI":"10.1089\/thy.1995.5.407"},{"key":"2015080418004370000_173.3.297.2","doi-asserted-by":"crossref","unstructured":"Griebeler ML Gharib H Thompson GB . Medullary thyroid carcinoma. Endocrine Practice 2013 19 703\u2013711. (doi:10.4158\/EP12430.RA).","DOI":"10.4158\/EP12430.RA"},{"key":"2015080418004370000_173.3.297.3","doi-asserted-by":"crossref","unstructured":"Wells SA Jr Asa SL Dralle H Elisei R Evans DB Gagel RF Lee NY Machens A Moley JF Pacini F . Revised american thyroid association guidelines for the management of medullary thyroid carcinoma the american thyroid association guidelines task force on medullary thyroid carcinoma. Thyroid 2015 25 567\u2013610. (doi:10.1089\/thy.2014.0335).","DOI":"10.1089\/thy.2014.0335"},{"key":"2015080418004370000_173.3.297.4","unstructured":"Romei C Pardi E Cetani F Elisei R . Genetic and clinical features of multiple endocrine neoplasia types 1 and 2. Journal of Oncology 2012 2012 705036. (doi:10.1155\/2012\/705036)."},{"key":"2015080418004370000_173.3.297.5","doi-asserted-by":"crossref","unstructured":"Eng C . Multiple endocrine neoplasia type 2 and the practice of molecular medicine. Reviews in Endocrine & Metabolic Disorders 2000 1 283\u2013290. (doi:10.1023\/A:1026514301172).","DOI":"10.1023\/A:1026514301172"},{"key":"2015080418004370000_173.3.297.6","doi-asserted-by":"publisher","DOI":"10.1053\/ejso.2000.0981"},{"key":"2015080418004370000_173.3.297.7","doi-asserted-by":"crossref","unstructured":"Gharib H McConahey WM Tiegs RD Bergstralh EJ Goellner JR Grant CS van Heerden JA Sizemore GW Hay ID . Medullary thyroid carcinoma: clinicopathologic features and long-term follow-up of 65 patients treated during 1946 through 1970. Mayo Clinic Proceedings 1992 67 934\u2013940. (doi:10.1016\/S0025-6196(12)60923-9).","DOI":"10.1016\/S0025-6196(12)60923-9"},{"key":"2015080418004370000_173.3.297.8","doi-asserted-by":"crossref","unstructured":"Machens A Dralle H . Prognostic impact of N staging in 715 medullary thyroid cancer patients: proposal for a revised staging system. Annals of Surgery 2013 257 323\u2013329. (doi:10.1097\/SLA.0b013e318268301d).","DOI":"10.1097\/SLA.0b013e318268301d"},{"key":"2015080418004370000_173.3.297.9","doi-asserted-by":"crossref","unstructured":"Rios A Rodriguez JM Acosta JM Balsalobre MD Torregrosa N Sola J Perez-Flores D Parrilla P . Prognostic value of histological and immunohistochemical characteristics for predicting the recurrence of medullary thyroid carcinoma. Annals of Surgical Oncology 2010 17 2444\u20132451. (doi:10.1245\/s10434-010-1021-4).","DOI":"10.1245\/s10434-010-1021-4"},{"key":"2015080418004370000_173.3.297.10","doi-asserted-by":"publisher","DOI":"10.1210\/jc.80.10.3088"},{"key":"2015080418004370000_173.3.297.11","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-1714"},{"key":"2015080418004370000_173.3.297.12","unstructured":"Mian C Pennelli G Barollo S Cavedon E Nacamulli D Vianello F Negro I Pozza G Boschin IM Pelizzo MR . Combined RET and Ki-67 assessment in sporadic medullary thyroid carcinoma: a useful tool for patient risk stratification. European Journal of Endocrinology\/European Federation of Endocrine Societies 2011 164 971\u2013976. (doi:10.1530\/EJE-11-0079)."},{"key":"2015080418004370000_173.3.297.13","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605056"},{"key":"2015080418004370000_173.3.297.14","doi-asserted-by":"crossref","unstructured":"DeLellis RA Rule AH Spiler I Nathanson L Tashjian AH Jr Wolfe HJ . Calcitonin and carcinoembryonic antigen as tumor markers in medullary thyroid carcinoma. American Journal of Clinical Pathology 1978 70 587\u2013594.","DOI":"10.1093\/ajcp\/70.4.587"},{"key":"2015080418004370000_173.3.297.15","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0044"},{"key":"2015080418004370000_173.3.297.16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2009.03666.x"},{"key":"2015080418004370000_173.3.297.17","doi-asserted-by":"crossref","unstructured":"Gawlik T d'Amico A Szpak-Ulczok S Skoczylas A Gubala E Chorazy A Gorczewski K Wloch J Jarzab B . The prognostic value of tumor markers doubling times in medullary thyroid carcinoma \u2013 preliminary report. Thyroid Research 2010 3 10. (doi:10.1186\/1756-6614-3-10).","DOI":"10.1186\/1756-6614-3-10"},{"key":"2015080418004370000_173.3.297.18","unstructured":"Laure Giraudet A Al Ghulzan A Auperin A Leboulleux S Chehboun A Troalen F Dromain C Lumbroso J Baudin E Schlumberger M . Progression of medullary thyroid carcinoma: assessment with calcitonin and carcinoembryonic antigen doubling times. European Journal of Endocrinology\/European Federation of Endocrine Societies 2008 158 239\u2013246. (doi:10.1530\/EJE-07-0667)."},{"key":"2015080418004370000_173.3.297.19","doi-asserted-by":"crossref","unstructured":"Pacini F Basolo F Elisei R Fugazzola L Cola A Pinchera A . Medullary thyroid cancer. An immunohistochemical and humoral study using six separate antigens. American Journal of Clinical Pathology 1991 95 300\u2013308.","DOI":"10.1093\/ajcp\/95.3.300"},{"key":"2015080418004370000_173.3.297.20","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19890315)63:6<1189::AID-CNCR2820630625>3.0.CO;2-J"},{"key":"2015080418004370000_173.3.297.21","doi-asserted-by":"crossref","unstructured":"Larena A Vierbuchen M Fischer R . Blood group antigen expression in malignant tumors of the thyroid: a parallel between medullary and nonmedullary carcinomas. Langenbecks Archiv f\u00fcr Chirurgie 1995 380 269\u2013272.","DOI":"10.1007\/BF00184101"},{"key":"2015080418004370000_173.3.297.22","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0425"},{"key":"2015080418004370000_173.3.297.23","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1940"},{"key":"2015080418004370000_173.3.297.24","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2008.0403"},{"key":"2015080418004370000_173.3.297.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2010.03900.x"},{"key":"2015080418004370000_173.3.297.26","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdp332"},{"key":"2015080418004370000_173.3.297.27","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-2368"},{"key":"2015080418004370000_173.3.297.28","doi-asserted-by":"crossref","unstructured":"Milman S Arnold JL Price M Negassa A Surks MI Fleischer N Whitney KD . Medullary thyroid cancer that stains negative for CA 19-9 has decreased metastatic potential. Endocrine Practice 2015 21 590\u2013594. (doi:10.4158\/EP14357.OR).","DOI":"10.4158\/EP14357.OR"},{"key":"2015080418004370000_173.3.297.29","doi-asserted-by":"crossref","unstructured":"Wu K Hou SM Huang TS Yang RS . Thyroid carcinoma with bone metastases: a prognostic factor study. Clinical Medicine. Oncology 2008 2 129\u2013134.","DOI":"10.4137\/CMO.S333"},{"key":"2015080418004370000_173.3.297.30","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0207"},{"key":"2015080418004370000_173.3.297.31","doi-asserted-by":"crossref","unstructured":"Romei C Ugolini C Cosci B Torregrossa L Vivaldi A Ciampi R Tacito A Basolo F Materazzi G Miccoli P . Low prevalence of the somatic M918T RET mutation in micro-medullary thyroid cancer. Thyroid 2012 22 476\u2013481. (doi:10.1089\/thy.2011.0358).","DOI":"10.1089\/thy.2011.0358"}],"container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/173\/3\/297.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/173\/3\/297.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:32:41Z","timestamp":1676392361000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/173\/3\/297\/6668102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9]]},"references-count":31,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.1530\/eje-15-0304","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9]]}}}