Citation Information :
Kumari N, Chaudhary N, Krishnani N. Association of Biochemical and Histological Features with Parafibromin, Galectin-3, and PGP9.5 in Parathyroid Neoplasms. World J Endoc Surg 2019; 11 (1):6-14.
Background: Carcinoma in parathyroid is diagnosed when there is recurrence or metastasis or fulfillment of histological criteria. Immunohistochemical (IHC) markers are used to assist in difficult cases. Associations of IHC markers with unfavorable clinical or histological features that predict aggressive behavior of parathyroid neoplasms have not been reported so far. We planned to study the direct association of IHC markers with biochemical and histological features in parathyroid neoplasms.
Materials and methods: IHC for parafibromin (PF), adenosis polyposis coli (APC), galectin-3 (Gal-3), and PGP9.5 was performed and correlated with biochemical and histological features.
Result: PF loss, Gal-3, and PGP9.5 overexpression alone or in combination showed significant association with one or more features like hypercalcemic crisis; low serum vitamin D; raised serum alkaline phosphatase (ALP); diffuse sheet pattern; predominant oncocytic histology; diffuse macronucleoli; thick fibrous bands; and capsular, vascular, and adjacent tissue invasion. The majority of histological features that significantly correlated with the expression or loss of IHC makers is included in the current criteria for diagnosing malignancy in parathyroid neoplasms.
Conclusion: The presence of hypercalcemic crisis and predominant oncocytic histology showed significant association with IHC markers related to parathyroid malignancy. Inclusion of these features in current criteria may make it more comprehensive for predicting malignancy in parathyroid neoplasms, though the search for reliable factors predicting malignancy still continues.
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