Weber C J, Russell J, Chryssochoos J T, Hagler M, McGarity W C
Department of Surgery, Emory University School of Medicine, Surgical Research, 1639 Pierce Drive, WMB 5105, Atlanta, Georgia 30308, U.S.A.
World J Surg. 1996 Oct;20(8):1010-4; discussion 1014-5. doi: 10.1007/s002689900154.
The purpose of this study was to clarify the pathophysiology of primary hyperparathyroidism by looking for differences between parathyroids from eucalcemic patients and patients with primary hyperparathyroidism (HPT) with respect to the following parameters: intracellular parathyroid content of parathyroid hormone (PTH) and parathyroid hormone messenger RNA (PTH mRNA); and serum PTH and calcium levels of patients and patient age. Coded samples of human parathyroid biopsies were assayed for PTH content with a C-terminal-specific radioimmunoassay. Total cellular RNA was extracted, and PTH mRNA was quantified by dot-blot analysis. These results were tabulated along with associated data on patient age, preoperative serum PTH, and preoperative calcium levels. The content of PTH was significantly higher in true normal (TN) parathyroids than in parathyroids from patients with hyperparathyroidism. PTH content of adenomas and hyperplasias were similar. PTH content of normal parathyroids biopsied from patients with parathyroid adenomas (NA) was statistically higher than that of adenomas but statistically lower than that of TN parathyroids. PTH mRNA and PTH content were correlated (p < 0.001) for TN parathyroid glands; however, it was not true for glands (grossly normal or otherwise) in patients with HPT. Patient groups were similar with regard to mean patient age and intracellular PTH mRNA levels. Hypercalcemic patients were similar with regard to preoperative serum calcium and PTH levels. NA parathyroids, adenomas, and hyperplasias are different from TN parathyroids with regard to their PTH content. PTH mRNA was similar across all groups. The relation between intracellular PTH mRNA and PTH was significantly absent in patients with HPT compared with TN glands. Furthermore, we have found that PTH content of normal parathyroid in patients with adenoma is similar to that of hyperplastic and adenoma tissues. These data suggest that the PTH content of parathyroid tissues may be of use in differentiating normal from abnormal parathyroids.
本研究的目的是通过寻找血钙正常患者与原发性甲状旁腺功能亢进症（HPT）患者甲状旁腺在以下参数方面的差异，来阐明原发性甲状旁腺功能亢进症的病理生理学：甲状旁腺激素（PTH）和甲状旁腺激素信使核糖核酸（PTH mRNA）的细胞内甲状旁腺含量；以及患者的血清PTH和钙水平及患者年龄。采用C端特异性放射免疫分析法检测人甲状旁腺活检编码样本的PTH含量。提取总细胞RNA，并通过斑点印迹分析对PTH mRNA进行定量。将这些结果与患者年龄、术前血清PTH和术前钙水平的相关数据一起制成表格。真正正常（TN）甲状旁腺中的PTH含量显著高于甲状旁腺功能亢进症患者的甲状旁腺。腺瘤和增生组织的PTH含量相似。从甲状旁腺腺瘤（NA）患者活检的正常甲状旁腺的PTH含量在统计学上高于腺瘤，但在统计学上低于TN甲状旁腺。TN甲状旁腺的PTH mRNA与PTH含量相关（p<0.001）；然而，HPT患者的腺体（大体正常或其他情况）并非如此。患者组在平均患者年龄和细胞内PTH mRNA水平方面相似。高钙血症患者在术前血清钙和PTH水平方面相似。NA甲状旁腺、腺瘤和增生组织在PTH含量方面与TN甲状旁腺不同。所有组的PTH mRNA相似。与TN腺体相比，HPT患者细胞内PTH mRNA与PTH之间的关系明显不存在。此外，我们发现腺瘤患者正常甲状旁腺的PTH含量与增生组织和腺瘤组织的相似。这些数据表明，甲状旁腺组织的PTH含量可能有助于区分正常与异常甲状旁腺。
