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[甲状旁腺癌患者术前预测因素及临床特征分析]

[Analysis of preoperative predictive factors and clinical characteristics in patients with parathyroid carcinoma].

作者信息

Yao X A, Jiang T, Wei B B, Chang H

机构信息

Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

Department of Otolaryngology Head and Neck Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2018 Jun 23;40(6):428-432. doi: 10.3760/cma.j.issn.0253-3766.2018.06.006.

Abstract

To evaluate the clinical characteristics and preoperative predictive factors in patients with parathyroid carcinoma. From January 2010 to December 2016, 150 patients with pathologically and biochemically confirmed primary hyperparathyroidism were enrolled in this study. The clinical data were reviewed to define 28 cases of parathyroid hyperplasia, 14 cases of parathyroid carcinoma (PC), and 108 cases of parathyroid adenoma (PA). The clinical characteristics between PC and PA group were compared and analyzed to explore predictive factors for PC. Patients in PC group were significantly younger than those in PA group (47.9±13.9 vs 57.2±14.6 years, =0.026). The diameter of tumor in PC group was larger than that in PA group (3.6±1.8 vs 2.2±1.4 cm, =0.005). The levels of albumin-corrected serum calcium, parathyroid hormone (PTH), and alkaline phosphatase (AKP) were all higher in PC group than those in PA group (3.4±0.6 vs 2.9±0.3 mmol/l; 1 157.1 vs 201.6 pg/ml; 168 vs 97 IU/L; all <0.05). PC correlated with age(=-0.241, =0.007), albumin-corrected serum calcium (=0.324, <0.001), PTH levels (=0.301, =0.001), serum AKP (=0.217, =0.019) and tumor size(=0.238, =0.011). Receiver operator characteristic curve analysis showed that the optimum cut-off values as follows: albumin-corrected serum calcium 3.15 mmol/L, serum PTH concentration 1 011 pg/ml and tumor diameter 3.35 cm. These indicators can be helpful in the preoperative diagnosis of PC. Patients with PC were younger than the patients with PA. Albumin-corrected serum calcium, serum PTH concentration, and tumor diameter can be helpful in preoperative diagnosis of PC.

摘要

评估甲状旁腺癌患者的临床特征及术前预测因素。2010年1月至2016年12月,150例经病理及生化确诊的原发性甲状旁腺功能亢进患者纳入本研究。回顾临床资料以确定28例甲状旁腺增生、14例甲状旁腺癌(PC)和108例甲状旁腺腺瘤(PA)。比较并分析PC组和PA组的临床特征,以探索PC的预测因素。PC组患者明显比PA组患者年轻(47.9±13.9岁对57.2±14.6岁,P=0.026)。PC组肿瘤直径大于PA组(3.6±1.8 cm对2.2±1.4 cm,P=0.005)。PC组白蛋白校正血清钙、甲状旁腺激素(PTH)和碱性磷酸酶(AKP)水平均高于PA组(3.4±0.6对2.9±0.3 mmol/L;1157.1对201.6 pg/ml;168对97 IU/L;均P<0.05)。PC与年龄(r=-0.241,P=0.007)、白蛋白校正血清钙(r=0.324,P<0.001)、PTH水平(r=0.301,P=0.001)、血清AKP(r=0.217,P=0.019)及肿瘤大小(r=0.238,P=0.011)相关。受试者工作特征曲线分析显示最佳截断值如下:白蛋白校正血清钙3.15 mmol/L、血清PTH浓度1011 pg/ml及肿瘤直径3.35 cm。这些指标有助于PC术前诊断。PC患者比PA患者年轻。白蛋白校正血清钙、血清PTH浓度及肿瘤直径有助于PC术前诊断。

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