| Objective To evaluate and analyze the clinical features of sporadic parathyroid adenoma to improve the understanding of PHPT caused by sporadic parathyroid adenoma,which can provide a theoretical basis for its standardized diagnosis and treatment.Methods The clinical cases of 74 patients with parathyroid adenoma confirmed by pathology from August 2014 to August 2017 in the First Hospital of Jilin University were retrospectively analyzed.The data were analyzed by SPSS18.0.Results The ratio of male to female is 18:56 in 74 patients.The median age is 54(32-85)years.The course of disease is 1 to 20 years,the median of which is 3.5 months.There is no correlation between parathyroid adenoma and preoperative serum PTH,total calcium,phosphorus,alkaline phosphatase(P>0.05).99 m Tc-MIBI parathyroid imaging showed a higher rate of sporadic parathyroid adenoma.The detection rate of99 m Tc-MIBI parathyroid imaging for sporadic parathyroid adenoma was higher than that of ultrasound(P<0.005).Among 74 cases of parathyroid adenoma,13 cases(17.6%)show normal PTH,of which the ratio of male to female is 3:10,age is(54.69±16.74)years old,preoperative serum PTH,calcium,phosphorus and alkaline phosphatase are respectively 66.89±11.76pg/ml,2.41±0.41mmol/L,0.92±0.14mmol/L,77.99±25.60U/L.61cases(82.4%)of PHPT can be divided into asymptomatic PHPT(62.3%)and symptomatic PHPT(37.7%).Compared with symptomatic PHPT,asymptomatic PHPT has a shorter course(P<0.05)and lower value of preoperative PTH and serum calcium(P<0.05).The difference of serum PTH and calcium between preoperation and postoperation is small in contrast to symptomatic PHPT(P<0.05).There’re no significant differences in gender,age and preoperative serum phosphorus,alkaline phosphatase and postoperative serum PTH,calcium,phosphorus and adenoma between the two groups(P>0.05).The detection rate of asymptomatic PHPT with ultrasound is lower than that of symptomatic PHPT(P<0.05),and there is no significant difference in the detection of parathyroid imaging between the two groups(P>0.05).Conclusions The incidence of sporadic parathyroid adenoma is higher in women,and common in middle-aged and elderly people.Parathyroid adenoma can express normal PTH.The parathyroid adenoma of elevated PTH is mainly consisted of asymptomatic PHPT,of which the course is shorter and the value of preoperative serum PTH and Ca2+ is lower,compared with symptomatic PHPT.It suggests that asymptomatic PHPT may be a pre-existing course of symptomatic PHPT,which should be taken seriously in practices.The detection rate of asymptomatic PHPT with ultrasound is lower than that of symptomatic PHPT,and there is no significant difference in the detection of parathyroid imaging between the two groups. |
