Saggiorato Enrico, Bergero Nicoletta, Volante Marco, Bacillo Elisa, Rosas Rosj, Gasparri Guido, Orlandi Fabio, Papotti Mauro
Section of Endocrinology, University of Turin, Italy.
Am J Clin Pathol. 2006 Jul;126(1):59-66. doi: 10.1309/9NXP-7FRF-87MU-2PCK.
Hyperplastic and neoplastic parathyroid lesions may present overlapping morphologic features, and several markers have been proposed to distinguish benign from malignant growths. Recently, it was reported that galectin-3 is a useful marker of malignancy in uniglandular parathyroid diseases. To investigate galectin-3 and Ki-67 immunoexpression in parathyroid hyperplastic disease, 63 multiglandular lesions (13 primary, 40 secondary, and 10 tertiary hyperplasia cases) were analyzed and compared with 45 control cases of parathyroid adenomas and 24 carcinomas. Our data showed that hyperplastic lesions responsible for primary nonfamilial or tertiary hyperparathyroidism, as well as parathyroid adenomas, were negative for galectin-3, as opposed to carcinomas. In addition, secondary and familial primary hyperplasia cases were surprisingly positive for galectin-3 in approximately two thirds of cases. All hyperplastic lesions (positive or negative for galectin-3) had a low Ki-67 index. Based on these findings, secondary hyperplasia has a low proliferative potential but an unexplained galectin-3 reactivity, which reduces its diagnostic role in differentiating benign from malignant nodules in the context of multiglandular parathyroid diseases.
增生性和肿瘤性甲状旁腺病变可能呈现出重叠的形态学特征，人们已经提出了几种标志物来区分良性和恶性生长。最近，有报道称半乳糖凝集素-3是单发性甲状旁腺疾病中恶性肿瘤的有用标志物。为了研究半乳糖凝集素-3和Ki-67在甲状旁腺增生性疾病中的免疫表达，分析了63例多腺体病变（13例原发性、40例继发性和10例三发性增生病例），并与45例甲状旁腺腺瘤对照病例和24例癌病例进行了比较。我们的数据显示，与癌相反，导致原发性非家族性或三发性甲状旁腺功能亢进的增生性病变以及甲状旁腺腺瘤，半乳糖凝集素-3呈阴性。此外，继发性和家族性原发性增生病例中，约三分之二的病例半乳糖凝集素-3出人意料地呈阳性。所有增生性病变（半乳糖凝集素-3阳性或阴性）的Ki-67指数都很低。基于这些发现，继发性增生具有低增殖潜能，但半乳糖凝集素-3反应性无法解释，这降低了其在多腺体甲状旁腺疾病背景下区分良性和恶性结节的诊断作用。
