A Clinical Analysis Of60Cases Of Sporadic Parathyroid Adenoma

Objective: To investigate the early diagnosis and surgery treatment of sporadic parathyroid adenoma (PA).Methods:This study collected60patients with sporadic parathyroid adenoma, excluding familial parathyroid adenoma, multiple endocrine neoplasia (MEN) and secondary parathyroid hyperplasia caused by renal failure. All cases were confirmed adenoma or adenomatous hyperplasia by pathology. All patients underwent surgery from January2010to December2014, and were followed up until death or February14,2014. Clinical datas of patients were collected before surgery, one day,1month and6months after surgery, using SPSS software for data processing and analysising, to summarize the clinical symptoms, value of different imageological diagnoses and curative effect of surgical therapy of parathyroid adenomas.Results:This60patients hospitalized for many reasons, the ratio due to high serum calcium concentration was36.7%, due to parathyroid occupying found by imageological examination like B ultra was31.7%, due to ostalgia or rarefaction of bone was18.3%, and other reasons accounting for30%. In this series of patients with parathyroid adenoma, the correlation coefficient of preoperative serum PTH level and tumor size was0.457, P value<0.01, considering significant correlation between them. The correlation coefficient of preoperative preoperative serum total calcium concentration and preoperative serum PTH was0.39, P=0.003<0.01, considering significant correlation between them. The correlation coefficient of preoperative serum PTH and preoperative serum creatinine was0.474, P value<0.01considering significant correlation between them; The correlation coefficient of preoperative GFR and preoperative serum PTH was-0.035, P=0.801>0.01, there was no significant correlation between them. Preoperative and postoperative serum total calcium concentration:the correlation coefficient was0.405, P=0.002<0.01, considering the two were significantly associated, P value of the paired t test was<0.01, considering there is a significant difference; preoperative and postoperative serum PTH level:the correlation coefficient was0.141, P=0.367>0.05, there was no significant correlation between them, P value of the paired T-test was<0.01, believes there is a significant difference between them. The sensitivity and positive predictive value of various methods were:B Ultra78.95%(45/57) and90.00%(45/50); CT58.62%(34/58) and94.44%(34/36); parathyroid gland scintigraphy was87.5%(34/40) and97.14%(34/35). In the follow-up period, the PTH level declined of all patients after surgery, and there were41(68.3%) patients of whose serum total calcium concentration dropped to normal range. We saw no evidence of recurrence in our follow-ups, suggesting the efficiency of surgical treatment was100%.Conclusions:The clinical manifestations of parathyroid adenoma are diverse. Serum calcium concentration and parathyroid hormone determination help early diagnosis. B ulreasound, CT, MRI and99Tcm-MIBI parathyroid scintigraphy help diagnosing and positioning before surgery. Surgery is the preferred treatment of primary parathyroid adenoma, which can rapidly lower serum calcium and parathyroid hormone levels. In our follow-up, surgery was confirmed efficacy and of minimal risk of recurrence in the short term.