Miratashi Yazdi Seyed Amir, Nazar Elham
Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Pathol. 2022 Fall;17(4):395-405. doi: 10.30699/ijp.2022.551233.2865. Epub 2022 Aug 25.
The exact etiology of parathyroid carcinomas (PC) is still unknown. Their associations have with several inherited syndromes or specific genetic lesions have been established. The management of PC is challenging for clinicians. The complexity of molecular phenotypes increases with tumor aggressiveness. Lack of parafibromin on immunohistochemistry staining and HRPT2 mutation would be helpful in differentiation of carcinoma from adenoma. Lack of parafibromin expression, the gene product of HRPT2 is now used as a diagnostic, prognostic, and predictive marker for parathyroid carcinoma. The epigenetic alteration, for example, DNA methylation and modifications in the chromatin structure, are known as significant events involved in the parathyroid tumorigenesis. We suggest that adjuvant genetic and epigenetic target therapy should be considered in treatment of the patients with PC.
甲状旁腺癌（PC）的确切病因仍不清楚。其与几种遗传性综合征或特定基因病变的关联已被确定。PC的治疗对临床医生来说具有挑战性。分子表型的复杂性随着肿瘤侵袭性的增加而增加。免疫组织化学染色缺乏 parafibromin 以及 HRPT2 突变有助于将癌与腺瘤区分开来。缺乏 parafibromin 表达，即 HRPT2 的基因产物，现在被用作甲状旁腺癌的诊断、预后和预测标志物。表观遗传改变，例如 DNA 甲基化和染色质结构修饰，是甲状旁腺肿瘤发生过程中的重要事件。我们建议在PC患者的治疗中应考虑辅助性基因和表观遗传靶向治疗。
