Your browser doesn't support javascript.
loading
Evaluation of preoperative ultrasonographic and biochemical features of patients with aggressive parathyroid disease: is there a reliable predictive marker?
Cakir, Bekir; Polat, Sefika Burcak; Kilic, Mehmet; Ozdemir, Didem; Aydin, Cevdet; Süngü, Nuran; Ersoy, Reyhan.
Affiliation
  • Cakir, Bekir; Yildirim Beyazit University. Ataturk Education and Research Hospital. Ankara. TR
  • Polat, Sefika Burcak; Yildirim Beyazit University. Ataturk Education and Research Hospital. Ankara. TR
  • Kilic, Mehmet; Yildirim Beyazit University. Ataturk Education and Research Hospital. Ankara. TR
  • Ozdemir, Didem; Yildirim Beyazit University. Ataturk Education and Research Hospital. Ankara. TR
  • Aydin, Cevdet; Yildirim Beyazit University. Ataturk Education and Research Hospital. Ankara. TR
  • Süngü, Nuran; Yildirim Beyazit University. Ataturk Education and Research Hospital. Ankara. TR
  • Ersoy, Reyhan; Yildirim Beyazit University. Ataturk Education and Research Hospital. Ankara. TR
Arch. endocrinol. metab. (Online) ; 60(6): 537-544, Nov.-Dec. 2016. tab, graf
Article in En | LILACS | ID: biblio-827783
Responsible library: BR1.1
ABSTRACT
ABSTRACT Objective Parathyroid cancer (PC) represents < 1% of cases of PHPT. Tumors demonstrating atypical histopathologic features and don’t fulfill criteria for carcinoma are classified as atypical adenomas (APA). The purpose of this study was to determine a biochemical or ultrasonographic feature that can predict aggressive disease requiring more extensive surgery and closer follow-up. Subjects and methods Twenty eight patients operated for PHPT and diagnosed with atypical adenoma (23 patients) or carcinoma (5 patients) were enrolled in this study. The control group consisted of 102 patients operated between the same dates and diagnosed with classical PA. Classical adenomas, atypical adenomas, and carcinomas were compared according to their biochemical and ultrasonographic parameters. Results Serum Ca levels were significantly higher in the PC group compared with the APA and classical PA groups. Serum median PTH, Serum ALP and UCa was significantly higher in the APA and carcinoma groups compared to the classical PA group. ROC analysis was made to determine the best cut off values for predicting aggressive disease were 12.45 mg/dL, 265.05 pg/mL, 154.5 IU/l, 348.5 mg/day and 21.5 mm for Ca, PTH, ALP, UCa and the adenoma diameter, respectively. Multivariate analysis showed that serum Ca, ALP and isoechoic/cystic appearance were independent predictors for aggressive disease. Conclusion Preoperatively high PTH, ALP, and UCa levels and large lesions with isoechoic or cystic appearances may be predictive of atypical adenoma or carcinoma in patients being evaluated for PHPT. In such cases, surgeons may prefer en bloc parathyroidectomy to minimally invasive surgery.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: LILACS Main subject: Parathyroid Neoplasms / Biomarkers, Tumor / Adenoma Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Aged / Female / Humans / Male Language: En Journal: Arch. endocrinol. metab. (Online) Journal subject: ENDOCRINOLOGIA / METABOLISMO Year: 2016 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: LILACS Main subject: Parathyroid Neoplasms / Biomarkers, Tumor / Adenoma Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Aged / Female / Humans / Male Language: En Journal: Arch. endocrinol. metab. (Online) Journal subject: ENDOCRINOLOGIA / METABOLISMO Year: 2016 Document type: Article Affiliation country: Country of publication: