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PREDICTION AND DIAGNOSIS OF SPORADIC MULTIGLANDULAR PARATHYROID DISEASE BY THE METHOD OF MATHEMATICAL ANALYSIS
https://doi.org/10.57256/2949-0715-2022-1-50-56
Abstract
Background. Sporadic multiglandular parathyroid disease remains an unresolved problem in endocrine surgery. This is due to the complexity of clinical and laboratory prediction, insufficient sensitivity of imaging methods and intraoperative monitoring of intact parathyroid hormone.
Аim is to develop a predictive scale for multiple lesions of the parathyroid glands in primary hyperparathyroidism.
Materials and methods. A single-center prospective study was conducted, including 126 cases of surgical treatment of primary hyperparathyroidism (2019-2021). The main endpoint of the study was to develop a scale for predicting multiple PTG lesions in PHPT using the method of mathematical analysis.
Results. The developed scale includes determination of serum levels of albumin-corrected calcium and parathyroid hormone, glomerular filtration rate (GFR), measurement of parathyroid glands parameters according to ultrasound and/or scintigraphy and assessment of the consistency of these results and determination of the value of the coefficient KIB. The results are evaluated in points. If the total score is less than 2, multiglandular parathyroid disease is diagnosed, equal to or more than 2 - one gland.
Conclusion. Mathematical prediction of sporadic multiglandular parathyroid disease allows clarifying the preoperative diagnosis and planning the scope of surgical treatment.
For citations:
Ilyicheva E., Bersenev G. PREDICTION AND DIAGNOSIS OF SPORADIC MULTIGLANDULAR PARATHYROID DISEASE BY THE METHOD OF MATHEMATICAL ANALYSIS. Baikal Medical Journal. 2022;1(1):50-56. (In Russ.) https://doi.org/10.57256/2949-0715-2022-1-50-56
Background. Sporadic multiglandular parathyroid disease remains an unresolved problem in endocrine surgery. This is due to the complexity of clinical and laboratory prediction, insufficient sensitivity of imaging methods and intraoperative monitoring of intact parathyroid hormone.
Аim is to develop a predictive scale for multiple lesions of the parathyroid glands in primary hyperparathyroidism.
Materials and methods. A single-center prospective study was conducted, including 126 cases of surgical treatment of primary hyperparathyroidism (2019-2021). The main endpoint of the study was to develop a scale for predicting multiple PTG lesions in PHPT using the method of mathematical analysis.
Results. The developed scale includes determination of serum levels of albumin-corrected calcium and parathyroid hormone, glomerular filtration rate (GFR), measurement of parathyroid glands parameters according to ultrasound and/or scintigraphy and assessment of the consistency of these results and determination of the value of the coefficient KIB. The results are evaluated in points. If the total score is less than 2, multiglandular parathyroid disease is diagnosed, equal to or more than 2 - one gland.
Conclusion. Mathematical prediction of sporadic multiglandular parathyroid disease allows clarifying the preoperative diagnosis and planning the scope of surgical treatment.
References
1. Dedov I.I., Melnichenko G.A. Endocrinology. Clinical guidelines. Moscow: GEOTAR-Media; 2018:529 (In Russian).
2. Walker M.D., Silverberg S.J. Primary hyperparathyroidism, Nat. Rev. Endocrinol. 2018;14:115-125. https://doi.org/10.1038/nrendo.2017.104
3. Mokrysheva N.G., Eremkina A.K., Mirnaya S.S. et al. The clinical practice guidelines for primary hyperparathyroidism, short version. Problems of Endocrinology. 2021;67(4): 94-124 (In Russian). https://doi.org/10.14341/probl12801
4. De Gregorio L., Lubitz C.C., Hodin R.A. et al. The truth about double adenomas: Incidence, localization, and intraoperative parathyroid hormone. J Am Coll Surg. 2016:222(6):1044-1052. https://doi.org/10.1016/j.jamcollsurg.2015.12.048
5. Lew J.I., Solorzano C.C., Montano R.E. et al. Role of intraoperative parathormone monitoring during parathyroidectomy in patients with discordant localization studies. Surgery. 2008;144:299-306. https://doi.org/10.1016/j.surg.2008.03.039
6. Mihai R., Gleeson F., Buley I.D. et al. Negative imaging studies for primary hyperparathyroidism are unavoidable: Correlation of sestamibi and high-resolution ultrasound scanning with histological analysis in 150 patients. World J Surg. 2006;30(5):697-704. https://doi.org/10.1007/s00268-005-0338-9
7. Miller B.S., England B.G., Nehs M. et al. Interpretation of intraoperative parathyroid hormone monitoring in patients with baseline parathyroid hormone levels of < 100 pg/mL. Surgery. 2006;140(6):883-890. https://doi.org/10.1016/j.surg.2006.07.016
8. Kebebew E., Hwang J., Reiff E. et al. Predictors of single-gland vs multigland parathyroid disease in primary hyperparathyroidism: A simple and accurate scoring model. Arch Surg. 2006;141(8):777-782; discussion https://doi.org/10.1001/archsurg.141.8.777
9. Mazeh H., Chen H., Leverson G., Sippel R.S. Creation of a “Wisconsin index” nomogram to predict the likelihood of additional hyperfunctioning parathyroid glands during parathyroidectomy. Ann Surg. 2013;257(1):138-141.https://doi.org/10.1097/SLA.0b013e31825ffbe1
10. De Pasquale L., Lori E., Bulfamante A.M. et al. Evaluation of Wisconsin and CaPTHUS indices usefulness for predicting monoglandular and multiglandular disease in patients with primary hyperparathyroidism through the analysis of a single-center experience. Int J Endocrinol. 2021;2021:2040284. https://doi.org/10.1155/2021/2040284
11. Serradilla-Martín M., Palomares-Cano A., Cantalejo-Díaz M. et al. Usefulness of the Wisconsin and CaPTHUS indices for predicting multiglandular disease in patients with primary hyperparathyroidism in a southern European population. Gland Surg. 2021;10(3):861-869. https://doi.org/10.21037/gs-20-857
12. Bilezikian J.P., Brandi M.L., Eastell R. et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: Summary statement from the Fourth International Workshop. J Clin Endocrinol Metab. 2014;99(10):3561-3569. https://doi.org/10.1210/jc.2014-1413
13. Irvin G.L. 3rd, Solorzano C.C., Carneiro D.M. Quick intraoperative parathyroid hormone assay: surgical adjunct to allow limited parathyroidectomy, improve success rate, and predict outcome. World J Surg. 2004;28(12):1287-1292. https://doi.org/10.1007/s00268-004-7708-6
14. Barczyński M., Bränström R., Dionigi G., Mihai R.Sporadic multiple parathyroid gland disease – A consensus report of the European Society of Endocrine Surgeons (ESES). Langenbecks Arch Surg. 2015;400(8):887-905. https://doi.org/10.1007/s00423-015-1348-1
About the Authors
E.A. IlyichevaRussian Federation
G.A. Bersenev
Russian Federation
Supplementary files
Review
For citations:
Ilyicheva E., Bersenev G. PREDICTION AND DIAGNOSIS OF SPORADIC MULTIGLANDULAR PARATHYROID DISEASE BY THE METHOD OF MATHEMATICAL ANALYSIS. Baikal Medical Journal. 2022;1(1):50-56. (In Russ.) https://doi.org/10.57256/2949-0715-2022-1-50-56