Faculty of Medicine, Dentistry and Health, The University of Sheffield, United Kingdom.
Faculty of Medicine, Dentistry and Health, The University of Sheffield, United Kingdom.
Surgeon. 2021 Dec;19(6):e536-e548. doi: 10.1016/j.surge.2021.01.011. Epub 2021 Feb 26.
Parathyroid cancers are rare and difficult to distinguish from benign parathyroid tumours. Prediction of malignancy often relies on intraoperative assessment of invasion. Standard histology is also inadequate; especially in the absence of local invasion, lymph nodal disease and metastasis. The aim of this project was to systematically review published literature on potential bio-markers used for the diagnosis of parathyroid cancer.
Pubmed, Web of Science and Medline databases were searched. Inclusion criteria included English language papers published after 1985 and reporting on biomarkers in human studies of parathyroid cancer and benign disease.
118 relevant papers were appraised; all were observational studies. At least 2 papers studied 8 serum, 4 urine and 27 tissue biomarkers on the diagnosis of parathyroid cancer. Of these, 5 serum and 13 tissue markers have been demonstrated in at least one study to be statistically different in benign and malignant disease. We present a synthesis of data for each biomarker and measures of diagnostic accuracy where possible.
Consideration should be given to the use of a panel of biomarkers to review patients with suspected parathyroid cancer. A profile including serum calcium and PTH levels and tissue expression of APC, Parafibromin, PGP9.5, Galectin 3 and Ki67 is proposed. Systematic Review Registration Number - CRD42019127833.
甲状旁腺癌罕见，难以与良性甲状旁腺肿瘤区分。恶性肿瘤的预测通常依赖于术中侵袭性评估。标准组织学也不充分；特别是在缺乏局部侵犯、淋巴结疾病和转移的情况下。本项目旨在系统回顾已发表的关于甲状旁腺癌潜在生物标志物的文献。
在 Pubmed、Web of Science 和 Medline 数据库中进行了检索。纳入标准包括 1985 年后发表的、报告人类甲状旁腺癌和良性疾病生物标志物的英文论文。
评估了 118 篇相关论文；均为观察性研究。至少有 2 篇论文研究了 8 种血清、4 种尿液和 27 种组织生物标志物对甲状旁腺癌的诊断。其中，有 5 种血清和 13 种组织标志物在至少一项研究中显示良性和恶性疾病之间存在统计学差异。我们对每个生物标志物的数据进行了综合，并尽可能评估了诊断准确性。
应考虑使用一组生物标志物来评估疑似甲状旁腺癌患者。建议采用包括血清钙和 PTH 水平以及 APC、Parafibromin、PGP9.5、Galectin 3 和 Ki67 组织表达的组合。系统评价注册编号 - CRD42019127833。
