大甲状旁腺肿瘤有异型增生和癌的风险增加。

Large parathyroid tumors have an increased risk of atypia and carcinoma.

机构信息

Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

出版信息

Am J Surg. 2011 Aug;202(2):146-50. doi: 10.1016/j.amjsurg.2010.06.003. Epub 2011 Jan 21.

DOI:10.1016/j.amjsurg.2010.06.003

PMID:21256474

Abstract

BACKGROUND

Risk for atypia and carcinoma in large parathyroid tumors is not known. Atypia and carcinoma were determined in small (<2 g) and large (≥2 g) tumors in patients undergoing parathyroidectomy for primary hyperparathyroidism.

METHODS

The study was a retrospective analysis of a 5-year prospective database. Tumor weight, histopathology, age, gender, calcium, and parathyroid hormone levels were registered. Patients with 4-gland disease were not included.

RESULTS

Among 353 parathyroid tumors, 313 weighed <2 g and 40 weighed ≥2 g. There was no difference in age between groups. Patients with large tumors were more frequently men and had higher calcium and parathyroid hormone levels. Atypia was found in 4 of 313 (1.3%) and 7 of 40 (17.5%) small and large tumors, respectively (P < .05). Corresponding figures for carcinoma were 1 of 313 (.3%) and 2 of 40 (5.0%) (P < .05).

CONCLUSIONS

Large parathyroid tumors have increased risk for atypia and carcinoma. Even so, most large parathyroid tumors are benign.

摘要

背景

大型甲状旁腺瘤发生非典型性和癌的风险尚不清楚。本研究通过对原发性甲状旁腺功能亢进症患者行甲状旁腺切除术，分析了小（<2g）大和（≥2g）大甲状旁腺肿瘤中非典型性和癌的发生情况。

方法

这是一项为期 5 年的前瞻性数据库的回顾性分析。记录了肿瘤重量、组织病理学、年龄、性别、钙和甲状旁腺激素水平。不包括 4 腺体疾病患者。

结果

在 353 个甲状旁腺肿瘤中，313 个肿瘤<2g，40 个肿瘤≥2g。两组患者的年龄无差异。大肿瘤患者中男性更多，血钙和甲状旁腺激素水平更高。小肿瘤中 4 个（1.3%）和大肿瘤中 7 个（17.5%）存在非典型性（P<.05）。相应的癌发生率分别为小肿瘤 1 个（0.3%）和大肿瘤 2 个（5.0%）（P<.05）。