OMEPRAZOLE - CALCITONIN STIMULATION TEST FOR THE DIAGNOSIS FOLLOW-UP AND FAMILY SCREENING IN MEDULLARY-THYROID CARCINOMA

Medullary thyroid carcinoma (MTC) occurs sporadically but may also be inherited as part of the multiple endocrine neoplasia (MEN) type 2 syn drome. Screening of the patients and first degree relatives annually w ith basal and provocative tests for serum immunoreactive calcitonin (C T) levels is essential and enables potentially curative disease. Penta gastrin and calcium are the usual provocative agents used worldwide. W e used endogenous gastrin (GT) release achieved by omeprazole, 20 mg b .i.d., to stimulate CT in 9 MTC, in 3 MEN 2A family members, and in 50 healthy control subjects. A steady and significant increase both in G T and CT levels was achieved in 9 MTC patients and 3 of the 14 family members tested, whereas in healthy controls the CT increase stimulated by GT was insignificant. Preliminary results showed that this new, sa fe, cheap, and outpatient-basis test can be used in MTC diagnosis, fol low-up, and screening.