Do Biochemical Markers Reflect Parathyroid Adenoma Volume in Primary Hyperparathyroidism?

Area of Science:

• Endocrinology
• Surgical Oncology
• Biochemistry

Background:

• Primary hyperparathyroidism (PHPT) is a condition characterized by excessive parathyroid hormone (PTH) production.
• The relationship between biochemical markers and the actual size (burden) of parathyroid adenomas is crucial for clinical management.
• Existing studies show variability, necessitating further investigation into these correlations.

Purpose of the Study:

• To examine the association between preoperative biochemical markers and parathyroid adenoma volume.
• To compare adenoma volume assessed by ultrasonography versus histopathology.
• To determine which biochemical parameters best reflect adenoma burden in PHPT.

Main Methods:

• Retrospective analysis of 526 patients with solitary parathyroid adenoma.
• Recorded preoperative serum levels of calcium, PTH, vitamin D, phosphorus, albumin, and alkaline phosphatase (ALP).
• Calculated adenoma volume using both ultrasonographic and histopathological measurements; evaluated correlations.

Main Results:

• Corrected serum calcium showed a significant positive correlation with histopathological adenoma volume (r=0.249, p<0.001).
• Ultrasonographic and histopathological volumes were strongly correlated (r=0.68, p<0.001).
• Vitamin D negatively correlated with both volume measures; PTH, phosphorus, albumin, and ALP showed no significant associations or weak correlations.

Conclusions:

• Preoperative serum calcium is modestly associated with parathyroid adenoma volume, particularly histopathological volume.
• While serum calcium may offer some insight into adenoma burden, it does not fully represent it.
• These findings contribute to refining disease assessment and surgical planning in PHPT.