Endocrine Unit, Department of Pathophysiology, National and Kapodostrian University of Athens, Athens, Greece.
Neuroendocrinology. 2010;92(4):252-8. doi: 10.1159/000320940. Epub 2010 Oct 2.
Although a number of familiar syndromes are associated with primary hyperparathyroidism (PHP), there is no information regarding the prevalence of PHP in other sporadic neuroendocrine diseases. The aim of this study is to investigate the prevalence of PHP in our group of patients with gastric carcinoid (GC) type 1 tumors.
Twenty-six patients with biopsy-proven GC type 1 tumors were retrospectively studied. The diagnosis of PHP was suspected following elevated or high-normal serum calcium levels and elevated or inappropriate normal parathyroid hormone levels. Further tests for the localization of the hyperfunctioning parathyroid glands included neck ultrasound, (99m)Tc-SESTAMIBI scanning, and cervical or upper mediastinal MR imaging studies. Four control groups were also studied: two age- and sex-matched groups of individuals with (n = 49) and without (n = 34) thyroid autoimmunity and normal endoscopy of the stomach, a third group with nongastric neuroendocrine tumors (n = 68), and a fourth group with atrophic gastritis and hypergastrinemia, without gastric endocrine tumors (n = 30).
PHP was diagnosed in 4 (15.38%) patients with GC type 1 tumors compared to none of the 4 control groups. Three of the 4 patients with PHP were operated and proved to have a parathyroid adenoma. No statistically significant differences were observed between patients with or without PHP in mean gastrin and chromogranin A levels, number of lesions, ki-67 labeling index expression, and maximum GC type 1 tumor diameter.
PHP seems to be relatively common, approximately 15% in the present cohort, in patients with GC type 1 tumors. PHP should be actively looked for in such patients and treated accordingly.
尽管许多常见的综合征与原发性甲状旁腺功能亢进症（PHP）有关，但在其他散发性神经内分泌疾病中，关于 PHP 的患病率尚无信息。本研究旨在调查我们一组胃类癌 1 型肿瘤患者中 PHP 的患病率。
回顾性研究了 26 例经活检证实的胃类癌 1 型肿瘤患者。在血清钙水平升高或高正常水平和甲状旁腺激素水平升高或不适当的正常水平后，怀疑存在 PHP。进一步检测异位甲状旁腺功能亢进的定位包括颈部超声、（99m）Tc-SESTAMIBI 扫描以及颈部或上纵隔磁共振成像研究。还研究了四个对照组：两组年龄和性别匹配的个体，一组伴有（n=49）和不伴有（n=34）甲状腺自身免疫且胃内镜正常，一组患有非胃神经内分泌肿瘤（n=68），一组患有萎缩性胃炎和高胃泌素血症，无胃内分泌肿瘤（n=30）。
与 4 个对照组均无 PHP 相比，4 例胃类癌 1 型肿瘤患者中诊断出 PHP。4 例 PHP 患者中有 3 例接受手术并证实患有甲状旁腺瘤。在 PHP 患者和无 PHP 患者之间，平均胃泌素和嗜铬粒蛋白 A 水平、病变数量、ki-67 标记指数表达和最大胃类癌 1 型肿瘤直径均无统计学差异。
在本队列中，大约 15%的胃类癌 1 型肿瘤患者中 PHP 似乎较为常见。应积极寻找此类患者中的 PHP 并进行相应治疗。
