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Rapid intraoperative parathyroid hormone assay in fine needle aspiration for differential diagnosis in thyroid and parathyroid surgery
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Maria Rosa Pelizzo
Published/Copyright:
July 7, 2010
Abstract
Background: The purpose of our study was to investigate the efficacy of rapid intraoperative parathyroid hormone (rIO-PTH) analysis performed using material collected by fine needle aspiration as a parameter to distinguish anatomical structures which the surgeon is not able to identify clearly as parathyroid or lymph node during thyroid/parathyroid surgery. Before surgery, all patients gave written, informed consent.
Methods: We measured the rIO-PTH on 50 anatomical structures, 32 presumed parathyroids and 18 presumed lymph nodes from 22 patients, who underwent thyroid/parathyroid surgery between May and September 2009.
Results: The rIO-PTH values obtained on parathyroids ranged from 85.4 pmol/L to more than 2106 pmol/L, with a rIO-PTH median of 263.25 pmol/L. Results obtained on lymph nodes ranged from <0.52 pmol/L up to 20.4 pmol/L, with a rIO-PTH median equal to 1.31 pmol/L. Results of the Mann-Whitney test showed a rIO-PTH median significantly different (p<0.0001) between samples obtained from parathyroid glands and lymph node tissue.
Conclusions: We demonstrated that rapid intraoperative measurement of parathyroid hormone is a good parameter for the differential diagnosis of parathyroid vs. lymph node tissue. We suggest extending the use of this technique to the field of parathyroid preservation during thyroid/parathyroid surgery in those cases where the parathyroids prove difficult to recognize on the basis of topographic or morphologic criteria.
Clin Chem Lab Med 2010;48:1313–7.
Received: 2009-12-17
Accepted: 2010-3-12
Published Online: 2010-07-07
Published in Print: 2010-09-01
©2010 by Walter de Gruyter Berlin New York
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Keywords for this article
parathyroid preservation;
parathyroidectomy;
rapid intraoperative parathyroid hormone
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- Retrospective analysis of 88,429 serum and urine glucose EQA results obtained from professional laboratories and medical offices participating in surveys organized by three European EQA centers between 1996 and 2007
- Liquid phase immunoassays utilizing magnetic markers and SQUID magnetometer
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