title: Expression of Ki-67, galectin-3, fragile histidine triad, and parafibromin in malignant and benign parathyroid tumors.
abstract: BACKGROUND
  It is widely recognized that the diagnosis of parathyroid carcinoma (PC) is often difficult because of the overlap of characteristics between malignant and benign parathyroid tumors, especially at an early stage. Our study aimed to investigate the differential expression of Ki-67, galectin-3, fragile histidine triad (FHIT) gene, and parafibromin in PC, parathyroid adenoma (PA), parathyroid hyperplasia (PH), and normal parathyroid (NP) tissues; then to assess these expression values for use in differential diagnosis of malignant and benign parathyroid tumors.
  
  
  METHODS
  Data of 15 cases with PC, 19 PAs, and 8 PHs were retrospectively analyzed for their clinical characteristics. The expression of Ki-67, galectin-3, FHIT, and parafibromin were detected via immunohistochemistry in the above-mentioned specimens and 6 NPs as control.
  
  
  RESULTS
  Complete loss of parafibromin expression was seen in 9 of 15 (60%) carcinomas, and all normal parathyroid tissues and parathyroid benign tumors stained positive for parafibromin except for one (4%) adenoma. Galectin-3 staining was positive in 11 of 15 (73%) carcinomas, 5 of 19 (26%) adenomas, 1 of 8 (12%) hyperplasias, and 0 of 6 normal tissues. The Ki-67 proliferative index was high in 4 of 15 (27%) carcinomas, 1 of 19 (5%) adenomas, and none of the hyperplasia or normal tissues. FHIT expression did not differ appreciably among the tumor types. The combination of overexpression of galectin-3 or loss of parafibromin increased sensitivity for PC to 87%, while the specificity of both positive galectin-3 and positive Ki-67 could reach 100%.
  
  
  CONCLUSIONS
  These data suggested that loss of parafibromin and overexpression of galectin-3 and Ki-67 might help to distinguish parathyroid carcinoma from other parathyroid tumors. And the combination of two or three of these markers might produce better sensitivity and/or specificity for the diagnosis of parathyroid carcinoma.
authors.affiliation: Key Laboratory of Endocrine, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Ou
authors.initials: O
authors.lastname: Wang
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Wang
authors.forename: Jie
authors.initials: J
authors.lastname: Shi
authors.forename: Min
authors.initials: M
authors.lastname: Nie
authors.forename: Wei-Bo
authors.initials: WB
authors.lastname: Xia
authors.forename: Mei
authors.initials: M
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiang
authors.forename: Heng
authors.initials: H
authors.lastname: Guan
authors.forename: Xun-Wu
authors.initials: XW
authors.lastname: Meng
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Xing
mesh_terms: D017766:Acid Anhydride Hydrolases / Q000378:metabolism*; D037502:Galectin 3 / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism*; D009363:Neoplasm Proteins / Q000378:metabolism*; D010282:Parathyroid Neoplasms / Q000378:metabolism*; D025521:Tumor Suppressor Proteins / Q000378:metabolism*; D000099170:Bis(5'-adenosyl)triphosphatase
chemical_list: D017766:Acid Anhydride Hydrolases; D037502:Galectin 3; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D025521:Tumor Suppressor Proteins; D000099170:Bis(5'-adenosyl)triphosphatase; C454900:CDC73 protein, human