Diagnostic value of rapid parathyroid hormone combined with 99Tc m-MIBI SPECT dual-phase imaging in suspected parathyroid tumor / 中华内分泌外科杂志

Objective:To investigate the diagnostic efficacy of 99Tc m-MIBI SPECT dual-phase imaging combined with rapid parathyroid hormone detection in thyroid cancer with suspected parathyroid mass. Methods:Data of 76 cases of thyroid cancer with suspected cervical parathyroid gland tumors receiving colorectal ultrasonography or CT examination in Thyroid Surgery Department of the Affiliated Cancer Hospital of Zhengzhou University were retrospectively analyzed. Blood samples were taken before surgery to detect parathyroid hormone. Parathyroid hormone was quickly detected after clamping the tumor blood vessels during surgery. Based on the postoperative pathological results, the sensitivity, specificity, accuracy and consistency of various diagnostic methods were evaluated. The ROC curve was drawn by measuring the value of the parathyroid gland concentration after reduction of the tumor blood vessels by clamping the tumor.Results:The sensitivity and accuracy of the 99Tc m-MIBI SPECT dual-phase imaging combined with the rapid detection of parathyroid hormone in diagnosis of suspected parathyroid tumors were (96.5%, 93.4%) better than the 99Tc m-MIBI SPECT dual-phase imaging methods (77.6%, 78.9%) and intraoperative rapid detection methods (86.2%, 82.8%) , and had a high consistency with the results of pathological examination, Kappa value of 0.81. The combined detection rate of suspected parathyroid tumors was significantly higher than that of 99Tc m-MIBI SPECT dual-phase imaging and rapid intraoperative detection, but there was no significant difference between 99Tc m-MIBI SPECT dual-phase imaging and intraoperative rapid detection. The area under the ROC curve of the reduction ratio a value after clamping the blood vessels of the tumor was 0.774, and the standard error was 0.073. The difference was statistically significant ( P<0.001,95% CI:0.631-0.918) . According to the results obtained by the ROC, the index (sensitivity + specificity-1) was plotted on the ordinate and a was the abscissa. The maximum value of the Jordan index was 0.584. The a value corresponding to this point was 0.52. 0.52 is the DCP value. The corresponding sensitivity, specificity, accuracy was 86.2%,72.2%,and 82.9%. Conclusion:99Tc m-MIBI SPECT dual-phase imaging combined with rapid parathyroid hormone detection during surgery has good diagnostic value for thyroid cancer with suspected parathyroid mass, and is completely consistent with pathological diagnosis.

Identification of two lncRNA scores in diagnosis of parathyroid tumors / 中华内分泌代谢杂志

Objective:Our previous micro-array study revealed that long non-coding RNA (lncRNA), such as ENST00000538790 and NR_125790, were differently expressed in parathyroid carcinoma compared with those in parathyroid adenoma. Diagnostic value of lncRNAs (ENST00000538790 and NR_125790) and scoring models derived from these lncRNAs in parathyroid carcinoma were investigated in this study.Methods:Fifty-seven fresh tissue samples from patients with hyperparathyroidism were collected. Eleven patients were diagnosed with parathyroid carcinoma, while 46 patients were found with parathyroid adenoma. The expression levels of five lncRNAs (ENST00000511928, ENST00000538790, ENST00000618339, NR_125790, and ENST00000485384) were detected with realtime quantitative PCR (RT-qPCR). LncRNA scores were calculated using these lncRNAs, and their value in parathyroid carcinoma diagnosis were also assessed.Results:It was found that expression levels of ENST00000511928 and ENST00000538790 were up-regulated in parathyroid carcinoma compared with parathyroid adenoma ( P<0.05), while the levels of ENST00000618339, NR_125790, and ENST00000485384 were decreased in parathyroid carcinoma ( P<0.05). Among these lncRNAs, ENST00000538790 and NR_125790 were independent risk factors for parathyroid carcinoma ( P<0.05). Hence, "log score" and "logistic score" were calculated with ENST00000538790 and NR_125790 levels. The areas under the receiver operating characteristic curve for "log score" and "logistic score" were up to 0.935 and 0.943 respectively in parathyroid carcinoma ( P<0.05), and were found to be greater than those from single lncRNA or classic clinical indices, such as serum calcium ( P<0.05). Conclusion:LncRNA scores with lncRNA ENST00000538790 and NR_125790 may play potential role in diagnosis of parathyroid carcinoma.

Hypercalcemia in a Patient with Polycythemia Vera / 전남의대학술지

A 59-year-old female with diabetes mellitus presented with hypercalcemia and polycythemia. Her serum calcium and intact parathyroid hormone (iPTH) levels were increased, and Tc-99m sesta-MIBI scanning showed hot uptake in the lower portion of the left thyroid lobe. After parathyroidectomy, her calcium, iPTH, and polycythemia were normalized. In conclusion, the differential diagnosis of polycythemia and hypercalcemia should also include the possibility of a parathyroid tumor in addition to other neoplasms.

Hypercalcemia in a Patient with Polycythemia Vera / 전남의대학술지

A 59-year-old female with diabetes mellitus presented with hypercalcemia and polycythemia. Her serum calcium and intact parathyroid hormone (iPTH) levels were increased, and Tc-99m sesta-MIBI scanning showed hot uptake in the lower portion of the left thyroid lobe. After parathyroidectomy, her calcium, iPTH, and polycythemia were normalized. In conclusion, the differential diagnosis of polycythemia and hypercalcemia should also include the possibility of a parathyroid tumor in addition to other neoplasms.

The Clinical Analysis of Parathyroid Tumor / 中国医师杂志

Objective To evaluate the clinical parameter, diagnosis and operative mode of parathyroid tumor. Methods The clinical symptoms, examination methods and the mode of operation in 15 operated patients with parathyroid tumor from May 1979 to October 2001 were retrospectively analyzed. Results 15 patients with parathyroid tumors, including 10 adenomas, 3 carcinoma and 2 cysts, all revealed the symptom of hyperparathyroidism except 2 cases of cyst. The accuracy of B-US and CT in preoperative diagnosis on location was 86 7% and 91 7% respectively, and their accuracy in preoperative diagnosis on quality was 26 7% and 75 0% respectively. All patients were treated by surgery. Among them, 12 patients were cured, 1 died, and 2 relapsed. Conclusion If a patient has the symptoms of bone pain, nephrolith and the mass in neck, we should consider whether he suffers from parathyroid tumor. B-US is the first choice in preoperative diagnosis on tumor location, and CT was the good examination method for tumor location also. The diagnosis on tumor quality dependeds on pathological examination mostly. Surgery remains to be the most important. The only unilateral exploration for the benign parathyroid tumor is performed and the operative range of parathyroid carcinoma should include both the mass and thyroid.