title: Trial to predict malignancy of affected parathyroid glands in primary hyperparathyroidism.
abstract: Parathyroid cancer is rare but relatively frequent in Japan compared to Western countries. Surgical parathyroidectomy is the primary choice for radical treatment of primary hyperparathyroidism (pHPT), hence it is important to distinguish malignant from benign tumor in the determination of surgical indication as well as method of operation. However, it is not easy to diagnose parathyroid cancer prior to operation. In the present study, we analyzed the background data, biochemical data and bone mineral density (BMD) of 131 patients with pHPT (111 benign and 20 malignant). BMD of the lumbar spine and mid-radius was measured by dual-energy X-ray absorptiometry. Serum levels of calcium, alkaline phosphatase (ALP), and parathyroid hormone (PTH) were significantly higher in malignant group compared to benign one. The extent of elevation of mid PTH seemed to be higher than that of intact PTH in malignant group. Age-, gender-, and race-adjusted BMD of distal one-third of radius was significantly decreased in malignant group compared to benign one, although that of lumbar spine was not significantly different between the two groups, indicating that osteopenia was marked in the region which was rich in cortical bone in malignant group. On the other hand, serum levels of calcium, ALP, and mid PTH as well as age were selected as predictors of malignancy in univariate logistic regression analysis, while serum level of intact PTH was not selected. In conclusion, radial BMD was lower in malignant group compared to benign one in pHPT. Serum levels of calcium, ALP and mid PTH were useful to predict malignancy of affected parathyroid glands in pHPT patients.
authors: Division of Endocrinology/Metabolism, Neurology and Hematology/Oncology, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Japan.
authors: Qingxiang
authors: Q
authors: Chen
authors: Hiroshi
authors: H
authors: Kaji
authors: Rikako
authors: R
authors: Nomura
authors: Hideaki
authors: H
authors: Sowa
authors: Mika
authors: M
authors: Yamauchi
authors: Tatsuo
authors: T
authors: Tsukamoto
authors: Toru
authors: T
authors: Yamaguchi
authors: Akira
authors: A
authors: Kobayashi
authors: Toshitsugu
authors: T
authors: Sugimoto
authors: Kazuo
authors: K
authors: Chihara
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000032:analysis; D015519:Bone Density; D002118:Calcium / Q000097:blood; D002277:Carcinoma / Q000209:etiology*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000150:complications* / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000209:etiology*; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D000469:Alkaline Phosphatase; D002118:Calcium