ECE2020 Audio ePoster Presentations Bone and Calcium (121 abstracts)
Can serum calcium, phosphorus and parathyroid hormone levels predict histopathological diagnosis in patients with primary hyperparathyroidism?
Ahmet Dirikoc 1 , Husniye Baser 1 , Fatma Neslihan Cuhaci Seyrek 1 , Burcak Polat 1 , Berna Ögmen 1 , Abbas Ali Tam 1 , Cevdet Aydın 1 , Aylin Kilic Yazgan 2 , Mehmet Kilic 3 , Didem Ozdemir 1 , Oya Topaloglu 1 , Reyhan Ersoy 1 & Bekir Cakir 1
1Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Endocrinology and Metabolism; 2Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Pathology; 3Ankara Yildirim Beyazit University, Faculty of Medicine, Department of General Surgery,
Aim: While the histopathological diagnosis is parathyroid adenoma in majority of patients with primary hyperparathyroidism (PHPT),parathyroid hyperplasia, atypical parathyroid adenoma or parathyroid carcinoma can be seen in others. Although it is known that serum calcium (Ca) and parathyroid hormone (PTH) levels are higher in patients with parathyroid carcinoma, there are not any cut-off value for serum Ca, phosphorus (P) and PTH levels defined for different histopathological parathyroid lesions. In this study, we aimed to determine cutoff levels for serum Ca, P and PTH in different histopathological PHPT lesions.
Materials and methods: The data of 392 patients operated for PHPT were evaluated retrospectively. Patients were grouped as parathyroid hyperplasia, parathyroid adenoma and atypical parathyroid adenoma according to histopathological results. Three way ROC analysis was used to evaluate the performance of serum Ca, P and PTH to determine the three groups. It was shown that Volume Under Surface (VUS) higher than 0.17 was giving information beyond chance. Cut-off levels and correct classification rates (CCR) were calculated when the VUS value was significantly higher than 0.17.
Results: There were 19 patients with parathyroid hyperplasia, 343 with parathyroid adenoma and 31 with atypical parathyrod adenoma. Serum Ca, P and PTH levels were significantly different between groups (P = 0.026, P = 0.003 and P ≤ 0.001, respectively). Serum Ca was significantly lower in parathyroid hyperplasia group compared to other two groups (P = 0.032 and P = 0.036, respectively). Serum Ca was similar in patients with parathyroid adenoma and atypical parathyroid adenoma (P = 0.999) (Table 1). The performance of serum P and PTH to determine groups were not sufficient significantly (P >0.05). In determining the groups, only the VUS value of serum Ca was statistically significantly higher than 0.17 (P = 0.005). The cut-off values for the variable were determined as C1 = 10.73 mg/dl and C2 = 11.40 mg/dl, respectively.
Conclusion: In this study, we found that serum Ca levels can be predictive for the histopathological diagnosis in patients with PHPT. Serum Ca lower than 10.73 mg/dl, 10.73–11.40 mg/dl and >11.40 mg/dl were determined to predict parathyroid hyperplasia, parathyroidadenoma and atypical parathyroid adenoma, respectively.
| Parathyroid hyperplasia (n = 19) | Parathyroid adenoma (n = 342) | Atypical parathyroid adenoma (n = 31) | P | |
| Calcium (mg/dl) | 10.98 ± 1.31 | 11.39 ± 0.98 | 11.56 ± 1.24 | 0.026 |
| Phosphorus (mg/dl) | 3.83 ± 2.08 | 2.62 ± 0.69 | 2.35 ± 0.59 | 0.003 |
| Parathyroid hormone (pg/ml) | 806.71 ± 923.07 | 229.82 ± 311.67 | 402.54 ± 383.46 | <0.001 |
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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