[Nuclear DNA content of parathyroid tumor with hyperparathyroidism]

It is not easy to make a differential diagnosis among adenoma, hyperplasia and carcinoma with hyperparathyroidism (HPT). We investigated the flowcytometric nuclear DNA content and analysis of cell cycle for 29 patients (39 parathyroid glands) with HPT and 16 normal parathyroid glands at the Department of Surgery II, Fukushima Medical College. Flowcytometry was performed by EPICS 751 flowcytometer (Coulter Co.) in paraffin-embedded tissue. Each fraction of cell cycle was analyzed by the PARAI software program. All controls and secondary hyperplasia showed diploid. Aneuploid pattern was found in 27.6% of all HPTs (50% of carcinomas, 30% of adenomas and 6.7% of primary hyperplasia). The S phase fraction (SPF) and proliferative index (PI) were increased in carcinomas. PIs, especially the fraction of G2M, in primary and secondary hyperplasias were more decreased than those in normal controls and adenomas. Preoperative intact-PTH, c-PTH, ionized calcium, ALP and weight of parathyroid gland had no significant correlation with DNA ploidy, DNA index and SPF. PI had tended to correlate only with the weight of parathyroid gland. When DNA content shows aneuploid, high SPF or PI in parathyroid adenoma and hyperplasia, strict follow-up is required because of the malignant potential. If G2M or PI is lower, we should pay attention not to leave any remaining glands in parathyroidectomy in the light of hyperplasia.