ECE2018 Poster Presentations: Calcium and Bone Endocrine tumours and neoplasia (3 abstracts)
Somatostatin receptors 1 and 5 are novel markers of parathyroid tumor aggressiveness
Sara Storvall 1 , Helena Leijon 2 , Eeva Ryhänen 1 , Johanna Louhimo 3 , Caj Haglund 3 , Camilla Schalin-Jäntti 1 & Johanna Arola 2
1Division of Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 2Department of Pathology, Huslab and University of Helsinki, Helsinki, Finland; 3Department of Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Background: Parathyroid carcinoma (PC) is a rare cause of primary hyperparathyroidism (PHPT). Distinguishing PC from other tumours underlying PHPT can be difficult and sometimes malignant diagnosis can be made only after recurrence of the disease. Atypical parathyroid adenomas (APA) have similar histological features as PC but lack signs of invasive growth. The expression of somatostatin receptors (SSTR) 1–5 in parathyroid tumours, commonly expressed in other neuroendocrine tumors, is currently not known.
Aim: To examine immunohistochemical expression of SSTRs 1–5 in parathyroid tumours: parathyroid adenomas (PA), APAs and PCs.
Methods: Nationwide cohort of PC (n=32), age- and gender-matched PA (n=72) and APA (n=28) were used. TMA blocks were stained with antibodies for SSTR subtypes 1–5 and intensity (0–3) of cytoplasmic, nuclear and membrane expression was scored. Correlations of SSTRs with parafibromin, Ki-67, fibrous septae and biochemical and clinical characteristics were also analysed.
Results: Membrane expression was negligible for all receptor subtypes. Expression of SSTR 2-3 was negative. Nuclear SSTR1, nuclear and cytoplasmic SSTR4 and nuclear SSTR5 expression increased- and cytoplasmic SSTR5 decreased with tumour aggressiveness:
Expression of nuclear SSTR5 was related to decreased parafibromin expression (P=0.002). Serum calcium and parathyroid hormone concentrations correlated with expression of nuclear SSTR1 (P<0.001), inversely with nuclear SSTR5 (P<0.001) and positively with cytoplasmic SSTR5 (P=0.045). Tumor size, fibrous septae and Ki-67 were related to expression of nuclear SSTR1 (P=0.029, P<0.001, P=0.005) and SSTR5 (P=0.023, P<0.001, P<0.001)
| Receptors with statistical significance and their relative expression in the tumor groups | ||||
| PA | APA | PC | p-value | |
| Nuclear SSTR1 | 1.5% | 15% | 41% | <0.001 |
| Cytoplasmic SSTR4 | 29% | 40% | 56% | 0.027 |
| Nuclear SSTR4 | 31% | 51% | 62% | 0.008 |
| Nuclear SSTR5 | 15% | 51% | 69% | <0.001 |
| Cytoplasmic SSTR5 | 85% | 78% | 56% | 0.02 |
Conclusion: SSTR1 and SSTR5 expression may have a role in parathyroid tumour pathogenesis.
Volume 56
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Endocrine Abstracts
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