Galectin-3 and Ki-67 expression in multiglandular parathyroid lesions

Area of Science:

• Endocrinology
• Surgical Pathology
• Oncology

Background:

• Parathyroid lesions, both hyperplastic and neoplastic, exhibit overlapping features, necessitating reliable markers for malignancy diagnosis.
• Galectin-3 has shown promise as a marker for malignancy in uniglandular parathyroid diseases.

Purpose of the Study:

• To investigate the immunoexpression of galectin-3 and Ki-67 in multiglandular parathyroid hyperplastic lesions.
• To compare these markers in primary, secondary, and tertiary hyperplasia against parathyroid adenomas and carcinomas.

Main Methods:

• Analysis of 63 multiglandular lesions (primary, secondary, tertiary hyperplasia) and controls (45 adenomas, 24 carcinomas).
• Immunohistochemical assessment for galectin-3 and Ki-67 expression.

Main Results:

• Hyperplastic lesions of primary nonfamilial and tertiary hyperparathyroidism, along with adenomas, were galectin-3 negative.
• Carcinomas were galectin-3 positive.
• Secondary and familial primary hyperplasia showed surprising galectin-3 positivity in approximately two-thirds of cases.
• All hyperplastic lesions demonstrated a low Ki-67 index, indicating low proliferative potential.

Conclusions:

• Galectin-3 reactivity in secondary hyperplasia is unexplained and reduces its utility in differentiating benign from malignant parathyroid nodules in multiglandular disease.
• Ki-67 index is low across all hyperplastic lesions, suggesting limited proliferative capacity.