Flow-cytometric DNA analysis for pathological diagnosis of parathyroid carcinoma.

对49例原发性甲状旁腺功能亢进患者的68例石蜡包埋的甲状旁腺肿瘤进行了流式细胞术DNA分析（15例癌症-13例原发性和11例局部复发或转移性病变; 30例腺瘤; 5例增生-15例腺体）。在27%的癌症、10%的腺瘤和0%的增生病例中发现了明确的非整倍体证据。所有4例非整倍体癌患者均显示局部复发或/和远处转移，需要再次探查，其中1例死于该疾病。非异倍体癌11例，7例术后2 ~ 5年无复发，4例复发。然而，在后者中，2例在再次手术后3年和6年仍存在正常钙血症，另外2例存在轻度高钙血症。因此，这项研究表明，非整倍体的副甲状腺癌可能会表现出更多的恶性行为比非非整倍体的，虽然非整倍体的石蜡材料是不兼容的良性组织学诊断甲状旁腺tumors.63例原发性甲状旁腺增生手术切除的新鲜甲状旁腺肿瘤的DNA分析。其中3例为甲状旁腺癌转移灶。其余49例原发性病变包括4例组织学癌，41例腺瘤和4例增生（MEN 1型）。在100%的转移癌、75%的组织学癌、8%的腺瘤和50%的增生病例中发现了明确的非整倍体证据。因此，甲状旁腺癌比腺瘤更易发生异倍体。结论：在非家族性原发性甲状旁腺功能亢进症患者中，新鲜甲状旁腺肿瘤标本的流式细胞术DNA分析对肿瘤的病理诊断是一个有价值的辅助手段。

Flow cytometric DNA analysis was performed on 68 paraffin-embedded parathyroid tumors from 49 patients with primary hyperparathyroidism (15 cancers-13 primary and 11 locally recurrent or metastatic lesions; 30 adenomas; and 5 hyperplasia-15 glands). Unequivocal evidence of aneuploidy was found in 27% of cancer, 10% of adenoma, and 0% of hyperplasia cases. All 4 patients with aneuploid carcinoma have shown local recurrence or/and distant metastases and have required reexplorations, one of whom died of the disease. Of the 11 patients with non-aneu-ploid carcinoma, 7 patients have no recurrence 2 to 5 years after the initial operation, and 4 showed recurrence. Of the latter, however, 2 are living with normocalcemia 3 and 6 years after reoperation and 2 other are alive with mild hypercalcemia. Thus this study indicates that aneuploid parathroid carcinoma are likely to show more malignant behavior than non-aneuploid ones, although aneuploidy in paraffin materials is not incompatible with a benign histologic diagnosis of parathyroid tumors.Sixty-three patients operated on for primary hyperparathyroidism had DNA analysis from the excised fresh parathyroid tumors. Three of the tumors were metastatic lesions of parathyroid carcinoma. The remaining 49 primary lesions included 4 histologic carcinoma, 41 adenoma, and 4 hyperplasia (MEN type 1). Unequivocal evidence of aneuploidy was found in 100% of metastatic carcinoma, 75% of histologic carcinoma, and 8% of adenoma, and 50% of hyperplasia cases. Thus parathyroid carcinomas are apt to be aneuploid than adenomas. It is concluded that in patients with nonfamilial primary hyperparthyroidism, flow cytometric DNA analysis of parathyroid tumors from fresh meterials must be a valuable adjunct to the pathological diagnosis of carcinoma.