Kalsitonin, qon zardobi
Kod:9068
| Kabi | Kalsitonin |
|---|
Tahlil ma'lumotlari
Tadqiqot usuli
- Kimyoluminessent immunoanaliz (CLIA)
Kutilayotgan natija topshirish vaqti
1 kun
Maxsus tayyorlik
- Do not eat or drink anything except water for at least 12 hours before collection.
- If clinically acceptable, stop oral contraceptives one month before the test.
- Avoid strenuous exercise and significant emotional stress during the 24 hours preceding collection.
- Refrain from smoking for 3 hours before the blood draw.
Qanday foydalanish
Kalsitonin, qon zardobi (tireokalsitonin, CT) qalqonsimon bezning medullyar karsinomasida diagnostikani qo‘llab-quvvatlash, kasallik bosqichini aniqlash va davolashga javobni monitoring qilish uchun qo‘llanadi. Tireodektomiyadan so‘ng bazal qiymatlarning doimiy yuqori yoki oshib borishi qoldiq yoki qaytalanuvchi MTC ni baholashga yordam beradi. Ushbu analiz, shuningdek, mos klinik vaziyatlarda — masalan, MTC, feoxromotsitoma yoki birlamchi giperparatireoz mavjud bo‘lgan bemorlarda — ko‘p endokrin neoplaziya 2A turi (MEN2A/Sipple sindromi) ni aniqlashga ko‘maklashadi. Qo‘shimcha sifatida, bazal kalsitonin giperparatireoz, gipoparatireoz va birlamchi osteoporozni o‘z ichiga olgan kalsiy–fosfat buzilishlarini baholashga kiritilishi mumkin.
Cheklovlar
Qalqonsimon bezning C-hujayralari kalsitonin sekretsiya qiladi; uning plazmadagi yarim parchalanish davri taxminan 2–15 daqiqa. Zardob kalsiyi oshganda sekretsiya ortadi, kamayganda esa pasayadi. Kalsitonin osteotsit–osteoklast tizimlariga ta’sir qilib suyak rezorbsiyasini cheklaydi va zardobdagi kalsiy darajasini tushiradi, shu tariqa paratireoid gormoniga fiziologik muvozanatlovchi sifatida xizmat qiladi; bu regulyator o‘qi vitamin D3 tomonidan modulyatsiya qilinadi. Qalqonsimon bezning medullyar karsinomasida bazal kalsitonin konsentratsiyalari odatda o‘sma yukini aks ettiradi. Pentagastrin yoki tomir ichiga kalsiy kabi vositalar bilan provokatsion sinov erta C-hujayra patologiyasini aniqlashi mumkin: stimulatsiyadan keyingi ifodali ko‘tarilishlar MTC foydasiga, mo‘tadil yoki referens oralig‘ida qoladigan oshishlar esa erta C-hujayra giperplaziyasiga mos kelishi mumkin. MTC bo‘yicha tireodektomiyadan so‘ng kalsitoninni seriyali o‘lchash biokimyoviy sog‘ayishni aniqlashga va perzistent yoki qaytalanuvchi kasallikni kuzatuvga yordam beradi. Kalsitonin sekretsiyasi qalqonsimon bezdan tashqari omillar bilan ham modulyatsiyalanishi mumkin; ularga oshqozon-ichak gormonlari (masalan, pepsin) va pankreatik glukagon kiradi. Pankreatobiliar va jigar kasalliklari — masalan, pankreatit, o‘tkir xoletsistit va sirroz — qondagi kalsitonin darajalariga ikkilamchi ta’sir ko‘rsatishi mumkin.
| O'lchov birligi | pg/mL | ||||
|---|---|---|---|---|---|
| Referens oraliq |
| ||||
| Ko'rsatmalar | Workup of suspected medullary thyroid carcinoma in the setting of thyroid nodules, goiter, or enlarged cervical lymph nodes, Assessment for MEN2A when pheochromocytoma or hyperparathyroidism is present, Preoperative baseline and postoperative surveillance for medullary thyroid carcinoma, Screening individuals with a family history of medullary thyroid carcinoma, Evaluation of possible osteoporosis as part of a calcium–phosphate metabolism panel, Assessment of calcium–phosphate balance in disorders such as hyperparathyroidism or hypoparathyroidism |
Natija og'ishlarining mumkin sabablari
Oshgan daraja
- estrogen therapy
- excess alcohol intake prior to testing
- hyperinsulinemia due to high carbohydrate load
- intravenous calcium administration
- strenuous exercise
Namunangiz talablari
| Namunangiz | Zardob |
|---|---|
| Container | Oltin/yo'lbars qopqoqli probirka (SST, gel ajratgich) |
| Hajm | 1 mL (min 0.5 mL) |
| Saqlash tayyorlik | Sovutilgan, Muzlatilgan |
References
Eur J Endocrinol. 2010 Jun;162(6):1141–5. Epub 2010 Mar 23. Calcitonin screening and pentagastrin testing: predictive value for the diagnosis of medullary carcinoma in nodular thyroid disease. Herrmann BL, Schmid KW, Goerges R, Kemen M, Mann K.
Otolaryngol Clin North Am. 1990 Jun;23(3):453-73. Surgical treatment of medullary carcinoma of the thyroid. Block M.A.
Calcitonin and bone formation: a knockout full of surprises. Mone Zaidi, Baljit S. Moonga, and Etsuko Abe. 2002, American Society for Clinical Investigation
Surgery. 2011 Dec;150(6):1168-77. Preoperative basal calcitonin and tumor stage correlate with postoperative calcitonin normalization in patients undergoing initial surgical management of medullary thyroid carcinoma. Yip DT, Hassan M, Pazaitou-Panayiotou K, Ruan DT, Gawande AA.
Presse Med. 2011 Dec;40(12 Pt1):1141–6. Epub 2011 Oct 27. Calcitonin: indications and interpretation. d'Herbomez M.
Rev Med Interne. 2006 Aug;27(8):610-5. Epub 2006 Apr 19. How to interprete hypercalcitoninemia? Levy-Bohbot N, Patey M, Larbre H, Hecart AC, Caron J, Delemer B.