Chudek Jerzy, Nagy Anetta, Kokot Franciszek, Podwinski Antoni, Wiecek Andrzej, Ritz Eberhard, Kovacs Gyula
Department of Nephrology, Endocrinology and Metabolic Diseases, Silesian Medical University, Katowice, Poland.
J Nephrol. 2007 Mar-Apr;20(2):164-72.
It has been well documented that gene and DNA alterations occur frequently in benign primary parathyroid adenomas as well as in parathyroid glands with secondary hyperplasia. However, it has not been shown whether a correlation exists between somatic DNA aberrations and clinical data.
We analyzed the frequency of chromosomal aberrations in adenomas obtained from 25 patients with primary hyperparathyroidism (pHPT) and 60 parathyroid nodules from 20 uremic patients with secondary hyperparathyroidism (sHPT). The relation of chromosomal aberrations to parathyroid hormone, as well as calcium and phosphate serum concentrations, was assessed. Allelic changes were evaluated by microsatellite allelotyping using 105 polymorphic markers.
Somatic chromosomal aberrations were found in 23 out of 25 adenomas, in hyperplastic lesions from 16 out of 20 patients. In pHPT as well as in sHPT a positive correlation was found between the number of chromosomal alterations and serum phosphate concentration (tau=0.270, p=0.05; and tau=0.362, p=0.03, respectively). Only in pHPT was a negative correlation of borderline significance between serum parathormone (PTH) and number of aberrated chromosomes noticed (tau=-0.258, p=0.07). There was no correlation between the number of DNA changes and serum concentration of calcium or tumor volume.
Hyperphosphatemia may increase the risk of specific and random chromosomal aberrations due to increasing proliferation rate of parathyroid cells in patients with sHPT.
已有充分文献证明，基因和DNA改变在良性原发性甲状旁腺腺瘤以及继发性增生的甲状旁腺中频繁发生。然而，尚未证实体细胞DNA畸变与临床数据之间是否存在相关性。
我们分析了25例原发性甲状旁腺功能亢进症（pHPT）患者的腺瘤以及20例尿毒症继发性甲状旁腺功能亢进症（sHPT）患者的60个甲状旁腺结节中的染色体畸变频率。评估了染色体畸变与甲状旁腺激素以及血清钙和磷浓度的关系。使用105个多态性标记通过微卫星等位基因分型评估等位基因变化。
25个腺瘤中有23个发现体细胞染色体畸变，20例患者中有16例增生性病变中发现染色体畸变。在pHPT和sHPT中，均发现染色体改变数量与血清磷浓度呈正相关（分别为tau = 0.270，p = 0.05；tau = 0.362，p = 0.03）。仅在pHPT中，血清甲状旁腺激素（PTH）与畸变染色体数量之间存在临界显著的负相关（tau = -0.258，p = 0.07）。DNA变化数量与血清钙浓度或肿瘤体积之间无相关性。
高磷血症可能由于sHPT患者甲状旁腺细胞增殖率增加而增加特定和随机染色体畸变的风险。
