The Role of Parafibromin, Galectin-3, HBME-1, and Ki-67 in the Differential Diagnosis of Parathyroid Tumors

Objectives: Parathyroid carcinoma (PC) is a rare parathyroid tumor compared to parathyroid adenoma (PA) and atypical parathyroid adenoma (APA). Recent studies have suggested parafibromin has a role in the differential diagnosis of parathyroid tumors. We sought to determine the role of parafibromin a...

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Main Authors: Serap Karaarslan, Fatma N. Yurum, Banu S. Kumbaraci, Emel E. Pala, Oya N. Sivrikoz, Mahir Akyildiz, Mehmet H. Bugdayci
Format: Article
Language:English
Published: Oman Medical Specialty Board 2015-11-01
Series:Oman Medical Journal
Subjects:
Online Access:http://www.omjournal.org/fultext_PDF.aspx?DetailsID=706&type=fultext
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author Serap Karaarslan
Fatma N. Yurum
Banu S. Kumbaraci
Emel E. Pala
Oya N. Sivrikoz
Mahir Akyildiz
Mehmet H. Bugdayci
author_facet Serap Karaarslan
Fatma N. Yurum
Banu S. Kumbaraci
Emel E. Pala
Oya N. Sivrikoz
Mahir Akyildiz
Mehmet H. Bugdayci
author_sort Serap Karaarslan
collection DOAJ
description Objectives: Parathyroid carcinoma (PC) is a rare parathyroid tumor compared to parathyroid adenoma (PA) and atypical parathyroid adenoma (APA). Recent studies have suggested parafibromin has a role in the differential diagnosis of parathyroid tumors. We sought to determine the role of parafibromin as well as galectin-3, Ki-67, and HBME-1 as diagnostic markers in the differential diagnosis of parathyroid tumors. Methods: A total of 92 cases diagnosed with PA, APA, or PC at Sifa University and Private Ege Pathology Laboratory between 2006–2012 were included in the study. Parafibromin (microarray), galectin-3, Ki-67, and HBME-1 were evaluated using immunohistochemistry in all parathyroid tumors. Results: Eighty-four cases were diagnosed with PA, six with APA, and two with PC. The study group consisted of 82 females and 10 males. Their mean age was 50.9 years, and the mean tumor diameter was 1.97 cm. Parafibromin was negative in the two PC cases but positive in all APA and PA cases. Positivity was observed with galectin-3 in 17 adenoma cases, three atypical adenomas, and two carcinoma cases. Positivity with HBME-1 was found in 26 PA cases and one PC case. Parafibromin and galectin-3 expression was significant between the three tumor groups but not for HBME-1 expression. Parafibromin expression increased in PA whereas galectin-3 expression decreased. A statistical significance was found between the three tumor groups according to the Ki-67 score (p=0.010). Additionally, the Ki-67 proliferation index was under 1% in PAs. Conclusion: The number of PCs in our series was small so our data mostly reflects the immunohistochemical characteristics of PAs. Parafibromin expression, galectin-3 negativity, and a Ki-67 proliferation index under 1% were estimated as beneficial in the differential diagnosis of difficult parathyroid tumors.
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spelling doaj.art-741a3c607ee7425ea1484a74733b9d812022-12-21T19:55:20ZengOman Medical Specialty BoardOman Medical Journal1999-768X2070-52042015-11-0130642142710.5001/omj.2015.84The Role of Parafibromin, Galectin-3, HBME-1, and Ki-67 in the Differential Diagnosis of Parathyroid TumorsSerap Karaarslan0Fatma N. Yurum1Banu S. Kumbaraci2Emel E. Pala3Oya N. Sivrikoz4Mahir Akyildiz5Mehmet H. Bugdayci6Pathology Department, Sıfa Unıversıty, Izmır, TurkeyPrivate Ege Pathology Laboratory, Izmır, TurkeyPathology Department, Ege Unıversıty, Izmır, TurkeyPathology Department, Tepecik Training And Research Hospıtal, Izmır, TurkeyPathology Department, Sıfa Unıversıty, Izmır, TurkeyGeneral Surgıcal Department, Ege University, Izmır, TurkeyPathology Department, Sıfa Unıversıty, Izmır, TurkeyObjectives: Parathyroid carcinoma (PC) is a rare parathyroid tumor compared to parathyroid adenoma (PA) and atypical parathyroid adenoma (APA). Recent studies have suggested parafibromin has a role in the differential diagnosis of parathyroid tumors. We sought to determine the role of parafibromin as well as galectin-3, Ki-67, and HBME-1 as diagnostic markers in the differential diagnosis of parathyroid tumors. Methods: A total of 92 cases diagnosed with PA, APA, or PC at Sifa University and Private Ege Pathology Laboratory between 2006–2012 were included in the study. Parafibromin (microarray), galectin-3, Ki-67, and HBME-1 were evaluated using immunohistochemistry in all parathyroid tumors. Results: Eighty-four cases were diagnosed with PA, six with APA, and two with PC. The study group consisted of 82 females and 10 males. Their mean age was 50.9 years, and the mean tumor diameter was 1.97 cm. Parafibromin was negative in the two PC cases but positive in all APA and PA cases. Positivity was observed with galectin-3 in 17 adenoma cases, three atypical adenomas, and two carcinoma cases. Positivity with HBME-1 was found in 26 PA cases and one PC case. Parafibromin and galectin-3 expression was significant between the three tumor groups but not for HBME-1 expression. Parafibromin expression increased in PA whereas galectin-3 expression decreased. A statistical significance was found between the three tumor groups according to the Ki-67 score (p=0.010). Additionally, the Ki-67 proliferation index was under 1% in PAs. Conclusion: The number of PCs in our series was small so our data mostly reflects the immunohistochemical characteristics of PAs. Parafibromin expression, galectin-3 negativity, and a Ki-67 proliferation index under 1% were estimated as beneficial in the differential diagnosis of difficult parathyroid tumors.http://www.omjournal.org/fultext_PDF.aspx?DetailsID=706&type=fultextGalectin-3HBME-1 antigenKi-67 AntigenParafibromin protein-humanImmunohistochemistryParathyroid Neoplasms
spellingShingle Serap Karaarslan
Fatma N. Yurum
Banu S. Kumbaraci
Emel E. Pala
Oya N. Sivrikoz
Mahir Akyildiz
Mehmet H. Bugdayci
The Role of Parafibromin, Galectin-3, HBME-1, and Ki-67 in the Differential Diagnosis of Parathyroid Tumors
Oman Medical Journal
Galectin-3
HBME-1 antigen
Ki-67 Antigen
Parafibromin protein-human
Immunohistochemistry
Parathyroid Neoplasms
title The Role of Parafibromin, Galectin-3, HBME-1, and Ki-67 in the Differential Diagnosis of Parathyroid Tumors
title_full The Role of Parafibromin, Galectin-3, HBME-1, and Ki-67 in the Differential Diagnosis of Parathyroid Tumors
title_fullStr The Role of Parafibromin, Galectin-3, HBME-1, and Ki-67 in the Differential Diagnosis of Parathyroid Tumors
title_full_unstemmed The Role of Parafibromin, Galectin-3, HBME-1, and Ki-67 in the Differential Diagnosis of Parathyroid Tumors
title_short The Role of Parafibromin, Galectin-3, HBME-1, and Ki-67 in the Differential Diagnosis of Parathyroid Tumors
title_sort role of parafibromin galectin 3 hbme 1 and ki 67 in the differential diagnosis of parathyroid tumors
topic Galectin-3
HBME-1 antigen
Ki-67 Antigen
Parafibromin protein-human
Immunohistochemistry
Parathyroid Neoplasms
url http://www.omjournal.org/fultext_PDF.aspx?DetailsID=706&type=fultext
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