Value of intraoperative parathyroid hormone monitoring in papillary thyroid cancer surgery: can it be used to guide the choice of operation methods?

ABSTRACT

BACKGROUND: To assess the diagnostic value of decreased parathyroid hormone (PTH) in hypoparathyroidism after unilateral operation. METHODS: A study was conducted on patients with PTC undergoing total or near-total thyroidectomy plus central neck dissection (CND). RESULTS: Postoperative hypocalcemia was found in 42 patients (51.2%). For patients undergoing bilateral CND, those whose tumor invasion proceeded beyond the thyroid capsule have a higher rate of postoperative hypoparathyroidism (P<0.05). PTH level of hypoparathyroidism patients was lower than that of non-hypoparathyroidism patients from surgery to 6 months later (P<0.05). When unilateral thyroidectomy and central region dissection were completed, PTH level decreased by 47.06% in hypoparathyroidism patients, which was significantly higher than non-hypoparathyroidism patients (28.35%) (P<0.001). PTH level (AUC 0.806) and its decreasing degree (AUC 0.736) played predicting roles in assessing postoperative hypoparathyroidism (P<0.001). CONCLUSIONS: For PTC surgery, PTH level and its decreasing degree played predicting roles in assessing postoperative hypoparathyroidism.