Gurrado Angela, Pasculli Alessandro, Avenia Nicola, Bellantone Rocco, Boniardi Marco, Merante Boschin Isabella, Calò Pietro Giorgio, Camandona Michele, Cavallaro Giuseppe, Cianchi Fabio, Conzo Giovanni, D'Andrea Vito, De Crea Carmela, De Pasquale Loredana, Del Rio Paolo, Di Meo Giovanna, Dionigi Gianlorenzo, Dobrinja Chiara, Docimo Giovanni, Famà Fausto, Galimberti Attilio, Giacomelli Laura, Graceffa Giuseppa, Iacobone Maurizio, Innaro Nadia, Lombardi Celestino Pio, Materazzi Gabriele, Medas Fabio, Mullineris Barbara, Oragano Luigi, Palestini Nicola, Perigli Giuliano, Pezzolla Angela, Prete Francesco Paolo, Raffaelli Marco, Renzulli Giuseppina, Rosato Lodovico, Scerrino Gregorio, Sgaramella Lucia Ilaria, Sorrenti Salvatore, Testini Carlotta, Veroux Massimiliano, Gasparri Guido, Testini Mario
Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University Medical School of Bari, 70124 Bari, Italy.
General and Endocrine Surgery Unit, S. Maria University Hospital, University of Perugia, 05100 Terni, Italy.
J Clin Med. 2023 Sep 29;12(19):6297. doi: 10.3390/jcm12196297.
Parathyroid cancer (PC) is a rare sporadic or hereditary malignancy whose histologic features were redefined with the 2022 WHO classification. A total of 24 Italian institutions designed this multicenter study to specify PC incidence, describe its clinical, functional, and imaging characteristics and improve its differentiation from the atypical parathyroid tumour (APT).
All relevant information was collected about PC and APT patients treated between 2009 and 2021.
Among 8361 parathyroidectomies, 351 patients (mean age 59.0 ± 14.5; F = 210, 59.8%) were divided into the APT (n = 226, 2.8%) and PC group (n = 125, 1.5%). PC showed significantly higher rates ( < 0.05) of bone involvement, abdominal, and neurological symptoms than APT (48.8% vs. 35.0%, 17.6% vs. 7.1%, 13.6% vs. 5.3%, respectively). Ultrasound (US) diameter >3 cm (30.9% vs. 19.3%, = 0.049) was significantly more common in the PC. A significantly higher frequency of local recurrences was observed in the PC (8.0% vs. 2.7%, = 0.022). Mortality due to consequences of cancer or uncontrolled hyperparathyroidism was 3.3%.
Symptomatic hyperparathyroidism, high PTH and albumin-corrected serum calcium values, and a US diameter >3 cm may be considered features differentiating PC from APT. 2022 WHO criteria did not impact the diagnosis.
甲状旁腺癌（PC）是一种罕见的散发性或遗传性恶性肿瘤，其组织学特征在2022年世界卫生组织分类中得到重新定义。24家意大利机构共同设计了这项多中心研究，以明确PC的发病率，描述其临床、功能和影像学特征，并改善其与非典型甲状旁腺肿瘤（APT）的鉴别诊断。
收集了2009年至2021年期间接受治疗的PC和APT患者的所有相关信息。
在8361例甲状旁腺切除术中，351例患者（平均年龄59.0±14.5岁；女性210例，占59.8%）被分为APT组（n = 226，占2.8%）和PC组（n = 125，占1.5%）。PC患者的骨受累、腹部和神经症状发生率显著高于APT（分别为48.8%对35.0%、17.6%对7.1%、13.6%对5.3%，P<0.05）。PC患者超声（US）直径>3 cm的情况明显更常见（30.9%对19.3%，P = 0.049）。PC患者局部复发的频率显著更高（8.0%对2.7%，P = 0.022）。癌症或无法控制的甲状旁腺功能亢进导致的死亡率为3.3%。
有症状的甲状旁腺功能亢进、高甲状旁腺激素（PTH）和白蛋白校正血清钙值以及US直径>3 cm可被视为区分PC与APT的特征。2022年世界卫生组织标准对诊断没有影响。
