Carnaille B M, Pattou F N, Oudar C, Lecomte-Houcke M C, Rocha J E, Proye C A
Departments of General and Endocrine Surgery and Pathology, University Hospital, CHU, 59037 Lille Cedex, France.
World J Surg. 1996 Sep;20(7):830-4; discussion 834. doi: 10.1007/s002689900126.
The aim of this study was to compare the clinical, biochemical, and pathologic findings of normocalcemic patients with macroscopically enlarged parathyroid tissue identified at thyroid surgery with those of patients treated surgically for preoperatively proved primary hyperparathyroidism (PHPT). The records of 28 patients with incidental parathyroid enlargement and 533 patients with PHPT were reviewed to compare age, sex, serum calcium and phosphate, intact parathyroid hormone (iPTH), parathyroid weight, number of diseased glands, cell and histologic types, PTH content, and cure rate. Incidentally found lesions were lighter and developed in younger patients. Biochemistry and pathology found them to be less hyperfunctioning. Sex, number of diseased glands per patient, and cell type were not different. PTH content was low in the incidental lesions. Incidentally discovered enlarged parathyroid glands are mildly hyperfunctioning at the time of discovery. They may represent an early stage of lesion responsible for overt PHPT. In the absence of knowledge concerning their significance and evolution, we recommend that enlarged parathyroids found during the course of a thyroid operation be removed.
本研究的目的是比较在甲状腺手术中发现的甲状旁腺组织宏观增大的血钙正常患者与术前确诊为原发性甲状旁腺功能亢进症（PHPT）并接受手术治疗的患者的临床、生化和病理结果。回顾了28例偶然发现甲状旁腺增大患者和533例PHPT患者的记录，以比较年龄、性别、血清钙和磷、完整甲状旁腺激素（iPTH）、甲状旁腺重量、病变腺体数量、细胞和组织学类型、PTH含量及治愈率。偶然发现的病变较轻，且发生在较年轻的患者中。生化和病理学检查发现它们的功能亢进程度较低。性别、每位患者病变腺体数量和细胞类型无差异。偶然病变中的PTH含量较低。偶然发现的增大的甲状旁腺在发现时功能轻度亢进。它们可能代表导致明显PHPT的病变的早期阶段。在不了解其意义和演变的情况下，我们建议切除在甲状腺手术过程中发现的增大的甲状旁腺。
