Soliter Paratiroid Adenom Hacminin Ameliyat Öncesi ve Sonrası Parathormon ve Kalsiyum Seviyeleri ile İlişkisi
Abstract
Amaç: Paratiroid boyutu, ağırlığı, pozisyonu ve histopatolojik özellikleri olası prediktif değer adayları olarak araştırılmıştır. Bu çalışmamızda bizde sonografik ölçümlerle hesaplanan paratiroid bezi hacmi ile postoperatif serum kalsiyum ve parathormon (PTH) düzeylerindeki azalma miktarı arasındaki ilişkiyi araştırmayı amaçladık.
Materyal ve Metot: Ameliyat öncesi ve sonrası düzeltilmiş kalsiyum ve intakt PTH plazma seviyeleri kaydedildi. Her bir adenomatöz paratiroid bezinin boyutu, “V=π/6 x çaplar” formülü kullanılarak, ameliyat öncesi sonografik ölçümlere dayalı olarak bir elips şeklinde hesaplandı.
Bulgular: Çalışmaya toplam 61 (%76,3) kadın ve 19 (%23,8) erkek dahil edildi. Hastaların medyan yaşı 58 idi. Adenomatöz paratiroid bezinin ortalama hacmi 13,4 cm3 olarak hesaplandı. Ameliyattan sonra hem kalsiyum hem de PTH'nin plazma seviyeleri önemli ölçüde azaldı (sırasıyla p<0,001, p<0,001). Adenom hacmi ile kalsiyum değerindeki değişiklik arasında anlamlı bir korelasyon varken (r: -0.500, p<0,001), PTH değeri için anlamlı bir ilişki yoktu (r: 0,036, p: 0,750).
Sonuç: Sonuçlarımız adenom hacmi ile plazma kalsiyum seviyeleri arasında bir ilişki olduğunu düşündürebilir ancak daha tutarlı sonuçlar için daha geniş hasta grupları ile daha kapsamlı çalışmalara ihtiyaç vardır.
Keywords
References
- 1. Duan K, Hernandez KG, Mete O. Clinicopathological correlates of hyperparathyroidism. J Clin Pathol. 2015;68(10):771-787. doi:10.1136/jclinpath-2015-203186
- 2. Hamidi S, Aslani A, Nakhjavani M, et al. Are biochemical values predictive of adenoma’s weight in primary hyperparathyroidism? ANZ J Surg. 2006;76(10):882–885. doi:10.1111/j.1445-2197.2006.03896.x.
- 3. Machado NN, Wilhelm SM. Diagnosis and Evaluation of Primary Hyperparathyroidism. Surg Clin North Am. 2019;99(4):649-666. doi:10.1016/j.suc.2019.04.006
- 4. Bilezikian JP. Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2018;103(11):3993-4004. doi: 10.1210/jc.2018-01225.
- 5. Insogna KL. Primary hyperparathyroidism. N Engl J Med. 2018;379(11):1050-1059. doi:10.1056/NEJMcp1714213
- 6. Yeh MW, Ituarte PHG, Zhou HC, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013;98(3):1122-1129. doi:10.1210/jc.2012-4022
- 7. Keidar Z, Solomonov E, Karry R, Frenkel A, Israel O, Mekel M. Preoperative [(99m)Tc]MIBI SPECT/CT Interpretation Criteria for Localization of Parathyroid Adenomas-Correlation with Surgical Findings. Mol Imaging Biol. 2017;19(2):265–270.
- 8. Al-Hraishawi H, Dellatore PJ, Cai X, Wang X. Intact parathyroid hormone levels and primary hyperparathyroidism. Endocr Res. 2017;42(3):241–245.
- 9. Stern S, Mizrachi A, Strenov Y, et al. Parathyroid adenoma: a comprehensive biochemical and histological correlative study. Clin Otolaryngol. 2017;42(2):381-386. doi:10.1111/coa.12761
- 10. Darbà J, Marsà A. Epidemiology and management of parathyroid gland disorders in Spain over 15 years: A retrospective multicentre analysis. PLoS One. 2020;15(3):e0230130. doi: 10.1371/journal.pone.0230130.
- 11. Randhawa PS, Mace AD, Nouraei SAR, Stearns MP. Primary hyperparathyroidism: Do perioperative biochemical variables correlate with parathyroid adenoma weight or volume? Clin Otolaryngol. 2007;32(3):179-184. doi:10.1111/j.1365-2273.2007.01447.x
- 12. Matsushita H, Hara M, Shishiba Y, Nakazawa H. An evaluation of the size of the parathyroid glands. Endocrinol Jpn. 1984;31(2):127-31. doi:10.1507/endocrj1954.31.127
- 13. Naples R, Thomas JD, Monteiro R, et al. Preoperative Calcium and Parathyroid Hormone Values Are Poor Predictors of Gland Volume and Multigland Disease in Primary Hyperparathyroidism: A Review of 2000 Consecutive Patients. Endocr Pract. 2022;28(1):77-82. doi:10.1016/j.eprac.2021.08.003
- 14. Gatu A, Velicescu C, Grigorovici A, et al. The volume of solitary parathyroid adenoma is related to preoperative PTH and 25OH-D3, but not to Calcium levels. Acta Endocrinol (Copenh). 2017;13(4):441-446. doi:10.4183/aeb.2017.441
- 15. Lin X, Fan Y, Zhang Z, Yue H. Clinical Characteristics of Primary Hyperparathyroidism: 15-Year Experience of 457 Patients in a Single Center in China. Front Endocrinol (Lausanne). 2021;12:602221. doi:10.3389/fendo.2021.602221
- 16. Jubran AF. Correlations between parathyroid hormone level, adenoma size, and serum calcium level in patients with primary hyperparathyroidism. Saudi Surgical Journal. 2018;6(4):122-12
The Relationship of Solitary Parathyroid Adenoma Volume with Pre- and Post-operative Parathormone and Calcium Levels
Abstract
Objective: Parathyroid size, weight, position and histopathological characteristics have been investigated as possible candidates of predictive value. We aimed to investigate the relationship between the volume of the parathyroid gland as calculated by sonographic measurements and the amount of postoperative decrease in serum calcium and parathyroid hormone (PTH) levels .
Materials and Methods: Preoperative and postoperative plasma levels of corrected calcium and intact PTH were noted. The size of each adenomatous parathyroid gland was calculated as an ellipsoid based on the preoperative sonographic measurements using the formula “V=π/6 x diameters”.
Results: A total of 61 (76.3%) females and 19 (23.8%) males were included in the study. The median age of the patients was 58 years. The average volume of the adenomatous parathyroid gland was calculated to be 13.4 cm3. Plasma levels of both calcium and PTH significantly decreased following surgery (p:0.000, p:0.000, respectively). There was significant correlation between the adenoma volume and the change in calcium value (r: -0.500, p:0.000) but not for the PTH value (r: 0.036, p:0.750).
Conclusion: Our significant results may suggest a relationship between the volume of adenoma and plasma calcium levels, but more extended studies with larger patient groups are needed for more consistent results.
Keywords
References
- 1. Duan K, Hernandez KG, Mete O. Clinicopathological correlates of hyperparathyroidism. J Clin Pathol. 2015;68(10):771-787. doi:10.1136/jclinpath-2015-203186
- 2. Hamidi S, Aslani A, Nakhjavani M, et al. Are biochemical values predictive of adenoma’s weight in primary hyperparathyroidism? ANZ J Surg. 2006;76(10):882–885. doi:10.1111/j.1445-2197.2006.03896.x.
- 3. Machado NN, Wilhelm SM. Diagnosis and Evaluation of Primary Hyperparathyroidism. Surg Clin North Am. 2019;99(4):649-666. doi:10.1016/j.suc.2019.04.006
- 4. Bilezikian JP. Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2018;103(11):3993-4004. doi: 10.1210/jc.2018-01225.
- 5. Insogna KL. Primary hyperparathyroidism. N Engl J Med. 2018;379(11):1050-1059. doi:10.1056/NEJMcp1714213
- 6. Yeh MW, Ituarte PHG, Zhou HC, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013;98(3):1122-1129. doi:10.1210/jc.2012-4022
- 7. Keidar Z, Solomonov E, Karry R, Frenkel A, Israel O, Mekel M. Preoperative [(99m)Tc]MIBI SPECT/CT Interpretation Criteria for Localization of Parathyroid Adenomas-Correlation with Surgical Findings. Mol Imaging Biol. 2017;19(2):265–270.
- 8. Al-Hraishawi H, Dellatore PJ, Cai X, Wang X. Intact parathyroid hormone levels and primary hyperparathyroidism. Endocr Res. 2017;42(3):241–245.
- 9. Stern S, Mizrachi A, Strenov Y, et al. Parathyroid adenoma: a comprehensive biochemical and histological correlative study. Clin Otolaryngol. 2017;42(2):381-386. doi:10.1111/coa.12761
- 10. Darbà J, Marsà A. Epidemiology and management of parathyroid gland disorders in Spain over 15 years: A retrospective multicentre analysis. PLoS One. 2020;15(3):e0230130. doi: 10.1371/journal.pone.0230130.
- 11. Randhawa PS, Mace AD, Nouraei SAR, Stearns MP. Primary hyperparathyroidism: Do perioperative biochemical variables correlate with parathyroid adenoma weight or volume? Clin Otolaryngol. 2007;32(3):179-184. doi:10.1111/j.1365-2273.2007.01447.x
- 12. Matsushita H, Hara M, Shishiba Y, Nakazawa H. An evaluation of the size of the parathyroid glands. Endocrinol Jpn. 1984;31(2):127-31. doi:10.1507/endocrj1954.31.127
- 13. Naples R, Thomas JD, Monteiro R, et al. Preoperative Calcium and Parathyroid Hormone Values Are Poor Predictors of Gland Volume and Multigland Disease in Primary Hyperparathyroidism: A Review of 2000 Consecutive Patients. Endocr Pract. 2022;28(1):77-82. doi:10.1016/j.eprac.2021.08.003
- 14. Gatu A, Velicescu C, Grigorovici A, et al. The volume of solitary parathyroid adenoma is related to preoperative PTH and 25OH-D3, but not to Calcium levels. Acta Endocrinol (Copenh). 2017;13(4):441-446. doi:10.4183/aeb.2017.441
- 15. Lin X, Fan Y, Zhang Z, Yue H. Clinical Characteristics of Primary Hyperparathyroidism: 15-Year Experience of 457 Patients in a Single Center in China. Front Endocrinol (Lausanne). 2021;12:602221. doi:10.3389/fendo.2021.602221
- 16. Jubran AF. Correlations between parathyroid hormone level, adenoma size, and serum calcium level in patients with primary hyperparathyroidism. Saudi Surgical Journal. 2018;6(4):122-12
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research article |
| Authors | |
| Early Pub Date | May 31, 2023 |
| Publication Date | June 6, 2023 |
| Submission Date | December 29, 2022 |
| Acceptance Date | March 14, 2023 |
| Published in Issue | Year 2023 Volume: 8 Issue: 2 |
