title: Preoperative predictive factors for parathyroid carcinoma in patients with primary hyperparathyroidism.
abstract: This study was conducted to review the clinical characteristics of parathyroid carcinoma (PC) and to evaluate potential preoperative predictive factors for PC in patients with primary hyperparathyroidism (PHPT). We performed a retrospective review of electronic medical records of 194 patients with pathologically confirmed PHPT in affiliated teaching hospitals of Seoul National University from January 2000 to March 2011. Adenoma was diagnosed in 171 patients, hyperplasia in 12, and carcinoma in 11. Several biochemical measurements were higher in patients with PC than in patients with benign disease, including serum total calcium (P < 0.001), intact parathyroid hormone (P = 0.003), and alkaline phosphatase (ALP) (P < 0.001). Tumors were larger in PC than in benign disease (P < 0.001). Multivariate analysis revealed that serum ALP level (P < 0.001) and tumor size were associated with PC (P = 0.03). Tumor size and serum ALP level were evaluated as preoperative predictive factors for PC using ROC analyses: a tumor size of 3.0 cm (sensitivity 90.9%, specificity 92.1%) and serum ALP level of 285 IU/L (83.3%, 97.0%) had predictive value for the diagnosis of PC in patients with PHPT. In conclusion, elevated serum ALP and a large parathyroid mass at the time of diagnosis can be helpful to predict PC in patients with PHPT.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Bae
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Choi
authors.forename: Yenna
authors.initials: Y
authors.lastname: Lee
authors.forename: Min Kyong
authors.initials: MK
authors.lastname: Moon
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Park
authors.forename: Chan Soo
authors.initials: CS
authors.lastname: Shin
authors.forename: Do Jun
authors.initials: DJ
authors.lastname: Park
authors.forename: Hak Chul
authors.initials: HC
authors.lastname: Jang
authors.forename: Seong Yeon
authors.initials: SY
authors.lastname: Kim
authors.forename: Sang Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000236:Adenoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood; D002277:Carcinoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000175:diagnosis*; D006965:Hyperplasia / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D010281:Parathyroid Hormone; D000469:Alkaline Phosphatase; D002118:Calcium