The relationship between adenoma weight and intact (1–84) parathyroid hormone level in primary hyperparathyroidism

Williams, John G.; Wheeler, Malcolm H.; Aston, Jacqueline; Brown, Richard C. D.; Woodhead, J. S.

doi:10.1016/0002-9610(92)90007-e

Cited by 49 publications

(51 citation statements)

References 11 publications

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“…This view is further supported by the finding of a higher risk of stone events before diagnosis. Parathyroid adenomas were larger and preoperative serum calcium concentrations were higher in our patients than in other surgical series, 14 15 supporting the theory of a delay in diagnosis.…”

Section: Discussionsupporting

confidence: 82%

Risk of renal stone events in primary hyperparathyroidism before and after parathyroid surgery: controlled retrospective follow up study

Mollerup

2002

BMJ

182

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Aim To study the risk of renal stone episodes and risk factors for renal stones in primary hyperparathyroidism before and after surgery. Design Register based, controlled retrospective follow up study. Setting Tertiary hospitals in Denmark. Participants 674 consecutive patients with surgically verified primary hyperparathyroidism. Each patient was compared with three age-and sex-matched controls randomly drawn from the background population. Hospital admissions for renal stone disease were compared between patients and controls. Risk factors for renal stones among patients were assessed. Main outcome measures Number of renal stone episodes; comparison of hospital admissions for renal stones in patients and controls; assessment of risk factors for renal stones. Results Relative risk of a stone episode was 40 (95% confidence interval 31 to 53) before surgery and 16 (12 to 23) after surgery. Risk was increased 10 years before surgery, and became normal more than 10 years after surgery. Stone-free survival 20 years after surgery was 90.4% in patients and 98.7% in controls (risk difference 8.3%, 4.8% to 11.7%). Patients with preoperative stones had 27 times the risk of postoperative stone incidents than controls. Before surgery, males had more stone episodes than females and younger patients had more stone episodes than older patients. Neither parathyroid pathology, weight of removed tissue, plasma calcium levels, nor skeletal pathology (fractures) influenced the risk of renal stones. After surgery, younger age, preoperative stones and ureteral strictures were significant risk factors for stones. Conclusions The risk of renal stones is increased in primary hyperparathyroidism and decreases after surgery. The risk profile is normal 10 years after surgery. Preoperative stone events increase the risk of postoperative stones. Stone formers and non-stone formers had the same risk of skeletal complications.

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Section: Discussionsupporting

confidence: 82%

Risk of renal stone events in primary hyperparathyroidism before and after parathyroid surgery: controlled retrospective follow up study

Mollerup

2002

BMJ

182

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“…Similar to our study, many studies have determined a positive correlation between the weight of the adenoma and serum PTH levels (16)(17)(18).…”

Section: Five Cell Types Have Been Identified In Normal Parathyroid Tsupporting

confidence: 88%

Morphological evaluation of parathyroid adenomas and immunohistochemical analysis of pcna and ki-67 proliferation markers

Demıralay

Altaca²,

Demirhan³

2011

TJPATH

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Objective: Parathyroid adenomas are the most common cause of primary hyperparathyroidism. Biological studies have shown that parathyroid adenomas are monoclonal proliferations. Up to date, five cell types have been identified in normal parathyroid tissues; chief cells, vacuolated chief cells, dark chief cells, oxyphil cells and transitional oxyphil cells. Most parathyroid adenomas are predominantly composed of chief cells.In this study, we aimed to indicate the relationship between the predominant cell type in parathyroid adenomas and proliferating cell nuclear antigen, Ki-67 antigen, and serum parathormone levels and the gland weight. Material and Method:15 cases who had a diagnosis of parathyroid adenomas were included in the study. Histopathologically, the predominant cell type was determined in all the cases. Paraffin blocks were immunohistochemically stained with proliferating cell nuclear antigen and Ki-67. Results:The average parathormone level of the cases was 239.52 ± 36.61 pg/ml before surgery. Mean gland weight was 1.69 ± 0.49 g. Two of the cases showed atypical adenoma characteristics. The predominant cell type was vacuolated chief cell. Immunohistochemical investigation showed that the mean average Ki-67 index value was 4.26 ± 0.86%. The mean proliferating cell nuclear antigen index was 93.20± 45.72/10³. There was a meaningful relationship between gland weights and serum parathormone levels. There was no meaningful relationship between predominant cell types and serum parathormone levels, proliferating cell nuclear antigen index, and Ki-67 index. The chief cell was identified as the predominant cell type. Conclusion Bulgular:Hastaların tümü kadın olup ortalama yaş 58 ± 13,36 olarak saptandı. Operasyon öncesi ortalama parathormon düzeyleri 239,52 ± 36,61 pg/ml idi. Bez ağırlıkları ortalama 1,69 ± 0,49 gr idi. Olgulardan biri lipoadenomdu. İki tanesi atipik adenom özellikleri göstermekteydi. Olgulardan 8 tanesinde baskın hücre tipi "berrak esas hücre", 6 tanesinde "esas hücre", 1 tanesinde ise "oksifil hücre" idi. İmmünohistokimyasal incelemelerde Ki-67 indeksi ortalama değeri % 4,26 ± 0,86 olarak saptandı. Prolifere hücre nükleer antijeni indeksi ortalama 93,20 ± 45,72/10³ olarak belirlendi. Bez ağırlıklarının serum parathormon düzeyleri üzerine anlamlı etkisi olduğu saptandı. Baskın olan hücre tiplerinin serum parathormon düzeyleri, Prolifere hücre nükleer antijeni indeksi, Ki-67 indeksi üzerine anlamlı etkisi olmadığı tespit edildi. Sonuç olarak çalışmamızda olguların çoğunda baskın hücre tipi esas hücre olarak saptanmıştır.

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“…This contradicts four previously published studies. 1,2,4,5 Our study has shown a difference when other studies have not, likely because of the exclusion of patients with double adenomas, primary parathyroid hyperplasia, secondary and tertiary hyperparathyroidism, and renal failure. This study also had a large sample size, which may have contributed to the positive results.…”

Section: Discussionmentioning

confidence: 55%

Correlation of biochemical parameters with single parathyroid adenoma weight and volume

et al. 2002

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The relationship between adenoma weight and intact (1–84) parathyroid hormone level in primary hyperparathyroidism

Cited by 49 publications

References 11 publications

Risk of renal stone events in primary hyperparathyroidism before and after parathyroid surgery: controlled retrospective follow up study

Risk of renal stone events in primary hyperparathyroidism before and after parathyroid surgery: controlled retrospective follow up study

Morphological evaluation of parathyroid adenomas and immunohistochemical analysis of pcna and ki-67 proliferation markers

Correlation of biochemical parameters with single parathyroid adenoma weight and volume

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