Parafibromin immunostainings of parathyroid tumors in clinical routine: a near-decade experience from a tertiary center View Full Text


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Article Info

DATE

2019-03-28

AUTHORS

C. Christofer Juhlin, Inga-Lena Nilsson, Kristina Lagerstedt-Robinson, Adam Stenman, Robert Bränström, Emma Tham, Anders Höög

ABSTRACT

The cell division cycle 73 gene is mutated in familial and sporadic forms of primary hyperparathyroidism, and the corresponding protein product parafibromin has been proposed as an adjunct immunohistochemical marker for the identification of cell division cycle 73 mutations and parathyroid carcinoma. Here, we present data from our experiences using parafibromin immunohistochemistry in parathyroid tumors since the marker was implemented in clinical routine in 2010. A total of 2019 parathyroid adenomas, atypical adenomas, and carcinomas were diagnosed in our department, and parafibromin staining was ordered for 297 cases with an initial suspicion of malignant potential to avoid excessive numbers of false positives. The most common inclusion criteria for immunohistochemistry were marked tumor weight (146 cases) and/or fibrosis (77 cases) and/or marked pleomorphism (58 cases). In total, 238 cases were informatively stained, and partial or complete loss of nuclear parafibromin immunoreactivity was noted in 40 cases; 10 out of 182 adenomas (5%), 27 out of 46 atypical adenomas (59%), and 7 out of 10 carcinomas (70%), with positive and negative predictive values of 85 and 90%, respectively for the detection of atypical adenomas/carcinomas versus adenomas, and 18 and 98%, respectively for carcinomas versus atypical adenomas/adenomas. Male patients with high-proliferative tumors were overrepresented among cases with aberrant parafibromin immunohistochemistry, and carcinomas more frequently harbored parafibromin aberrancies than atypical adenomas and adenomas (p < 0.001). We conclude that parafibromin immunohistochemistry is a useful marker in the clinical routine when applied on a pre-selected material of cases, with positive immunoreactivity as a confident rule out marker of malignancy. More... »

PAGES

1-13

References to SciGraph publications

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  • 2012-12. CDC73 mutations and parafibromin immunohistochemistry in parathyroid tumors: clinical correlations in a single-centre patient cohort in CELLULAR ONCOLOGY
  • 2014-11. Parafibromin, Galectin-3, PGP9.5, Ki67, and Cyclin D1: Using an Immunohistochemical Panel to Aid in the Diagnosis of Parathyroid Cancer in WORLD JOURNAL OF SURGERY
  • 2016-09-21. Dephosphorylated parafibromin is a transcriptional coactivator of the Wnt/Hedgehog/Notch pathways in NATURE COMMUNICATIONS
  • 2005-02. Parafibromin, product of the hyperparathyroidism-jaw tumor syndrome gene HRPT2, regulates cyclin D1/PRAD1 expression in ONCOGENE
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    http://scigraph.springernature.com/pub.10.1038/s41379-019-0252-6

    DOI

    http://dx.doi.org/10.1038/s41379-019-0252-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1113060313

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30923346


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