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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Procalcitonin in Medullary Thyroid Carcinoma: An Umbrella Review of Systematic Reviews and Meta-Analyses

  • Petra Petranović Ovčariček1,2
  • Alfredo Campennì3
  • Rosaria Maddalena Ruggeri4
  • Marija Punda2,5
  • Andrija Gregov2
  • Ana Bejuk5
  • Alberto F. Campennì6
  • Martin W. Huellner7,8
  • Luca Giovanella7,8,9
9 affiliations
  1. 1School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
  2. 2Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Vinogradska 29, 10000 Zagreb, Croatia
  3. 3Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98100 Messina, Italy
  4. 4Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV, 98125 Messina, Italy
  5. 5Department of Radiological Technology, University of Applied Health Sciences, Mlinarska Cesta 38, 10000 Zagreb, Croatia
  6. 6Medicine and Surgery Bachelor’s Degree Course, Department of Human Pathology of Adulthood and Childhood DETEV “G. Barresi”, University of Messina, 98125 Messina, Italy
  7. 7Department of Nuclear Medicine, University Hospital Zürich, Rämistrasse 100, 8091 Zürich, Switzerland
  8. 8Department of Nuclear Medicine, University of Zürich, Pestalozzistrasse 3, 8032 Zürich, Switzerland
  9. 9Department of Nuclear Medicine and Thyroid Center, Gruppo Ospedaliero Moncucco, Via Soldino 5, 6900 Lugano, Switzerland
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Abstract

Background/Objectives: Procalcitonin has been proposed as an alternative or complementary biomarker to calcitonin in medullary thyroid carcinoma (MTC). We synthesised the published systematic reviews, appraised their quality, and measured their reliance on the same primary studies. Methods: Umbrella review of systematic reviews reporting measured procalcitonin values in proven or suspected MTC. PubMed/MEDLINE and the Cochrane Library were searched to 30 June 2026. Quality was appraised with AMSTAR-2 and overlap as the corrected covered area (CCA). Results: Seven evidence syntheses (2015–2024) were included, four addressing procalcitonin itself and two with meta-analysis. Across diagnostic and monitoring populations, a bivariate meta-analysis of 11 studies and 5817 patients gave sensitivity of 0.90 (95% CI 0.71–0.97) and specificity of 1.00 (95% CI 0.85–1.00); in postoperative surveillance, five studies and 296 patients gave pooled sensitivity and specificity of 96%. The five syntheses enumerating their sources drew on 21 distinct primary reports, giving a corrected covered area of 38.1%, every pairwise value above the 15% threshold for very high overlap. Two primary studies were extracted discordantly; for one of them the same data yielded specificities of 84% and 5% depending on the threshold and assay platform applied. Confidence was low for one review and critically low for six. Conclusions: Procalcitonin is a promising adjunct to calcitonin, with better analytical behaviour, but routine combined measurement is not yet supported. The apparent consistency across syntheses reflects a shared and narrow primary literature rather than independent replication, and the absence of an agreed, method-specific threshold remains the main barrier to implementation.

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Cite

BibTeXRIS
BibTeX
@article{ovcaricek2026procalcitonin,
  title = {{Procalcitonin in Medullary Thyroid Carcinoma: An Umbrella Review of Systematic Reviews and Meta-Analyses}},
  author = {Petra Petranović Ovčariček and Alfredo Campennì and Rosaria Maddalena Ruggeri and Marija Punda and Andrija Gregov and Ana Bejuk and Alberto F. Campennì and Martin W. Huellner and Luca Giovanella},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218255},
  url = {https://www.mdpi.com/2077-0383/15/21/8255},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Procalcitonin in Medullary Thyroid Carcinoma: An Umbrella Review of Systematic Reviews and Meta-Analyses
AU  - Petra Petranović Ovčariček
AU  - Alfredo Campennì
AU  - Rosaria Maddalena Ruggeri
AU  - Marija Punda
AU  - Andrija Gregov
AU  - Ana Bejuk
AU  - Alberto F. Campennì
AU  - Martin W. Huellner
AU  - Luca Giovanella
PY  - 2026
DA  - 2026/10/23
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218255
UR  - https://www.mdpi.com/2077-0383/15/21/8255
AB  - Background/Objectives: Procalcitonin has been proposed as an alternative or complementary biomarker to calcitonin in medullary thyroid carcinoma (MTC). We synthesised the published systematic reviews, appraised their quality, and measured their reliance on the same primary studies. Methods: Umbrella review of systematic reviews reporting measured procalcitonin values in proven or suspected MTC. PubMed/MEDLINE and the Cochrane Library were searched to 30 June 2026. Quality was appraised with AMSTAR-2 and overlap as the corrected covered area (CCA). Results: Seven evidence syntheses (2015–2024) were included, four addressing procalcitonin itself and two with meta-analysis. Across diagnostic and monitoring populations, a bivariate meta-analysis of 11 studies and 5817 patients gave sensitivity of 0.90 (95% CI 0.71–0.97) and specificity of 1.00 (95% CI 0.85–1.00); in postoperative surveillance, five studies and 296 patients gave pooled sensitivity and specificity of 96%. The five syntheses enumerating their sources drew on 21 distinct primary reports, giving a corrected covered area of 38.1%, every pairwise value above the 15% threshold for very high overlap. Two primary studies were extracted discordantly; for one of them the same data yielded specificities of 84% and 5% depending on the threshold and assay platform applied. Confidence was low for one review and critically low for six. Conclusions: Procalcitonin is a promising adjunct to calcitonin, with better analytical behaviour, but routine combined measurement is not yet supported. The apparent consistency across syntheses reflects a shared and narrow primary literature rather than independent replication, and the absence of an agreed, method-specific threshold remains the main barrier to implementation.
SN  - 2077-0383
ER  -