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Conference Paper: Intraoperative parathyroid hormone (IOPTH) assay might be better than the second-generation assay in parathyroidectomy for primary hyperparathyroidism

TitleIntraoperative parathyroid hormone (IOPTH) assay might be better than the second-generation assay in parathyroidectomy for primary hyperparathyroidism
Authors
KeywordsPrimary Hyperparathyroidism
Parathyroid Neoplasm
Fluorocholine
Issue Date2021
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surg
Citation
The American Association of Endocrine Surgeons (AAES) Annual Meeting 2020, Birmingham, AL, 4-6 April 2020. In Surgery, 2021, v. 169 n. 1, p. 109-113 How to Cite?
AbstractBackground: It is unclear whether the third-generation intraoperative parathyroid hormone assay can improve surgical outcomes over second-generation assay in primary hyperparathyroidism. We aimed to compare the rate of decrease and diagnostic accuracy between the two assays after parathyroid adenoma excision. Methods: Consecutive patients undergoing parathyroidectomy with intraoperative parathyroid hormone were analyzed. Blood was drawn before and 10 minutes and 20 minutes after excision of the adenoma. The same blood sample was run simultaneously in the second-generation assays (Elecsys PTH STAT) and third-generation assays (Elecsys 1–84 PTH). Biochemical cure meant >50% intraoperative parathyroid hormone decrease at 10 minutes. Cure meant normocalcemia 6 months after operation. Results: Relative to the second-generation assay, the value of the intraoperative parathyroid hormone level was less in the third-generation assay before excision (P < .001), at 10 minutes (P < .001), and at 20 minutes (P < .001). The intraoperative parathyroid hormone rate of decrease and the proportion of normalized post-excision intraoperative parathyroid hormone were greater in the third-generation assay (P < .001), but the prediction accuracy appeared similar between the 2 (91.5% vs 91.0%). Patients with worse renal function (estimated glomerular filtration rate <80mL/min/1.73m2) had a slower intraoperative parathyroid hormone decrease in the second-generation but not in the third-generation assay. Conclusion: Despite comparable accuracy between the two generations of assay, the third-generation assay might be better than the second-generation assay because of the more rapid decrease in the intraoperative parathyroid hormone and a greater percentage of normalized intraoperative parathyroid hormone, regardless of baseline renal function.
Persistent Identifierhttp://hdl.handle.net/10722/282967
ISSN
2023 Impact Factor: 3.2
2023 SCImago Journal Rankings: 1.096
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, BHH-
dc.contributor.authorFung, MMH-
dc.date.accessioned2020-06-05T06:23:36Z-
dc.date.available2020-06-05T06:23:36Z-
dc.date.issued2021-
dc.identifier.citationThe American Association of Endocrine Surgeons (AAES) Annual Meeting 2020, Birmingham, AL, 4-6 April 2020. In Surgery, 2021, v. 169 n. 1, p. 109-113-
dc.identifier.issn0039-6060-
dc.identifier.urihttp://hdl.handle.net/10722/282967-
dc.description.abstractBackground: It is unclear whether the third-generation intraoperative parathyroid hormone assay can improve surgical outcomes over second-generation assay in primary hyperparathyroidism. We aimed to compare the rate of decrease and diagnostic accuracy between the two assays after parathyroid adenoma excision. Methods: Consecutive patients undergoing parathyroidectomy with intraoperative parathyroid hormone were analyzed. Blood was drawn before and 10 minutes and 20 minutes after excision of the adenoma. The same blood sample was run simultaneously in the second-generation assays (Elecsys PTH STAT) and third-generation assays (Elecsys 1–84 PTH). Biochemical cure meant >50% intraoperative parathyroid hormone decrease at 10 minutes. Cure meant normocalcemia 6 months after operation. Results: Relative to the second-generation assay, the value of the intraoperative parathyroid hormone level was less in the third-generation assay before excision (P < .001), at 10 minutes (P < .001), and at 20 minutes (P < .001). The intraoperative parathyroid hormone rate of decrease and the proportion of normalized post-excision intraoperative parathyroid hormone were greater in the third-generation assay (P < .001), but the prediction accuracy appeared similar between the 2 (91.5% vs 91.0%). Patients with worse renal function (estimated glomerular filtration rate <80mL/min/1.73m2) had a slower intraoperative parathyroid hormone decrease in the second-generation but not in the third-generation assay. Conclusion: Despite comparable accuracy between the two generations of assay, the third-generation assay might be better than the second-generation assay because of the more rapid decrease in the intraoperative parathyroid hormone and a greater percentage of normalized intraoperative parathyroid hormone, regardless of baseline renal function.-
dc.languageeng-
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surg-
dc.relation.ispartofSurgery-
dc.subjectPrimary Hyperparathyroidism-
dc.subjectParathyroid Neoplasm-
dc.subjectFluorocholine-
dc.titleIntraoperative parathyroid hormone (IOPTH) assay might be better than the second-generation assay in parathyroidectomy for primary hyperparathyroidism-
dc.typeConference_Paper-
dc.identifier.emailLang, BHH: Blang@hku.hk-
dc.identifier.authorityLang, BHH=rp01828-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.surg.2020.03.024-
dc.identifier.scopuseid_2-s2.0-85084407335-
dc.identifier.hkuros310146-
dc.identifier.volume169-
dc.identifier.issue1-
dc.identifier.spage109-
dc.identifier.epage113-
dc.identifier.isiWOS:000600403200018-
dc.publisher.placeUnited States-
dc.identifier.issnl0039-6060-

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