The prognostic value of ultrasound features and parafibromin expression in parathyroid carcinoma.

IF 3.5 2区 医学 Q2 GENETICS & HEREDITY Orphanet Journal of Rare Diseases Pub Date : 2025-03-04 DOI:10.1186/s13023-025-03608-4
Ruifeng Liu, Liyuan Ma, Yu Xia, Luying Gao, Jiang Ji, Yuang An, Aonan Pan, Nengwen Luo, Yuxin Jiang
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Abstract

Objectives: To investigate prognostic factors related with parathyroid carcinoma (PC) based upon ultrasound (US) parameters and parafibromin expression.

Methods: Between 2000/01 and 2022/07, thirty-four PC patients with detailed preoperative ultrasonography were enrolled in the research. Immunohistochemical staining of parafibromin was performed on pathological samples of these patients. Based on the expression of parafibromin, the cases were divided into a positive control group (parafibromin expression ≥ 10%) and a negative experimental group (parafibromin expression < 10%). The ultrasound and clinical features of the two groups were analyzed, and Cox regression was used to identify the independent prognostic factors regarding disease-free survival (DFS) and overall survival (OS).

Results: Among 34 patients with parathyroid carcinoma, 26 (76.5%) were parafibromin-positive, while 8 (23.5%) were parafibromin-negative. The mean follow-up time was 72.6 (11.0-179.3) months. During the overall survival period, 7 cases (20.6%) died, and 9 cases (26.5%) experienced recurrence or metastasis. The median overall survival time (interquartile range) was 65.7 (35.5-89.7) months, and the median disease-free survival time (interquartile range) was 38.2 (22.2-69.7) months. The risk of recurrence and metastasis in the parafibromin-negative group was 5.9 times higher than that in parafibromin-positive group (95% CI 1.569-22.190). PC patients with calcification on preoperative ultrasonography had a 9.4 times higher risk of death during the overall survival period compared with patients without calcification (95% CI 1.037-85.915). However, parafibromin expression did not show a significant impact on the prognosis of the overall survival.

Conclusions: Preoperative US-detected calcification within the lesion is an independent risk factor indicating the shorter OS for PC patients, while loss of parafibromin expression is significant for indicating the recurrence or metastasis of PC patients.

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甲状旁腺癌超声特征及副纤白蛋白表达的预后价值。
目的:探讨甲状旁腺癌(PC)的超声(US)参数及旁纤白蛋白(parafibromin)表达与预后的关系。方法:选取2000/01 ~ 2022/07年度行详细术前超声检查的PC患者34例作为研究对象。对这些患者的病理标本进行对异纤溴胺免疫组化染色。根据parafibromin的表达情况分为阳性对照组(parafibromin表达≥10%)和阴性实验组(parafibromin表达≥10%)结果:34例甲状旁腺癌患者中,parafibromin阳性26例(76.5%),parafibromin阴性8例(23.5%)。平均随访时间为72.6(11.0 ~ 179.3)个月。总生存期内死亡7例(20.6%),复发或转移9例(26.5%)。中位总生存时间(四分位数范围)为65.7(35.5-89.7)个月,中位无病生存时间(四分位数范围)为38.2(22.2-69.7)个月。副纤溴胺阴性组复发转移风险是副纤溴胺阳性组的5.9倍(95% CI 1.569 ~ 22.190)。术前超声检查有钙化的PC患者在总生存期内死亡风险是无钙化患者的9.4倍(95% CI 1.037 ~ 85.915)。然而,parafibromin的表达并没有显示出对总生存预后的显著影响。结论:术前us检测病变内钙化是提示PC患者生存期较短的独立危险因素,而parafibromin表达缺失是提示PC患者复发或转移的重要因素。
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来源期刊
Orphanet Journal of Rare Diseases
Orphanet Journal of Rare Diseases 医学-医学:研究与实验
CiteScore
6.30
自引率
8.10%
发文量
418
审稿时长
4-8 weeks
期刊介绍: Orphanet Journal of Rare Diseases is an open access, peer-reviewed journal that encompasses all aspects of rare diseases and orphan drugs. The journal publishes high-quality reviews on specific rare diseases. In addition, the journal may consider articles on clinical trial outcome reports, either positive or negative, and articles on public health issues in the field of rare diseases and orphan drugs. The journal does not accept case reports.
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