PMID- 37051192
OWN - NLM
STAT- MEDLINE
DCOM- 20230414
LR  - 20231106
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 14
DP  - 2023
TI  - Predicting multigland disease in primary hyperparathyroidism using ultrasound and 
      clinical features.
PG  - 1088045
LID - 10.3389/fendo.2023.1088045 [doi]
LID - 1088045
AB  - BACKGROUND: The identification of multigland disease (MGD) in primary 
      hyperparathyroidism (PHPT) patients is essential for minimally invasive surgical 
      decision-making. OBJECTIVE: To develop a nomogram based on ultrasound (US) 
      findings and clinical factors to predict MGD in PHPT patients. MATERIALS AND 
      METHODS: Patients with PHPT who had surgery between March 2021 and January 2022 
      were consecutively enrolled to this study. Biochemical and clinicopathological 
      data were recorded. US images were analyzed to extract US features for 
      prediction. Logistic regression analyses were used to identify MGD risk factors. 
      A nomogram was constructed based on these factors and its performance evaluated 
      by area under the receiver operating characteristic curve (AUC), calibration 
      curve, Hosmer-Lemeshow tests, and decision curve analysis (DCA). RESULTS: A total 
      of 102 PHPT patients were included; 82 (80.4%) had single-gland disease (SGD) and 
      20 (19.6%) had MGD. Using multivariate analyses, MGD was positively correlated 
      with age (odds ratio (OR) = 1.033, 95% confidence interval (CI): 0.190-4.047), 
      PTH levels (OR = 1.001, 95% CI: 1.000-1.002), multiple endocrine neoplasia type 1 
      (MEN1) (OR = 29.730, 95% CI: 3.089-836.785), US size (OR = 1.198, 95% CI: 
      0.647-2.088), and US texture (cystic-solid) (OR = 5.357, 95% CI: 0.499-62.912). 
      MGD was negatively correlated with gender (OR = 0.985, 95% CI: 0.190-4.047), 
      calcium levels (OR = 0.453, 95% CI: 0.070-2.448), and symptoms (yes) (OR = 0.935, 
      95% CI: 0.257-13.365). The nomogram showed good discrimination with an AUC = 0.77 
      (0.68-0.85) and good agreement in predicting MGD in PHPT patients. Also, 65 
      points was recommended as a cut-off value, with specificity = 0.94 and 
      sensitivity = 0.50. CONCLUSION: US was useful in evaluating MGD. Combining US and 
      clinical features in a nomogram showed good diagnostic performance for predicting 
      MGD.
CI  - Copyright (c) 2023 Luo, Jin, He, Fang, Wang, Liao, Li, Jiang, Zhu and Liu.
FAU - Luo, Yanwen
AU  - Luo Y
AD  - Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Science and Peking Union Medical College, Beijing, China.
FAU - Jin, Siqi
AU  - Jin S
AD  - Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Science and Peking Union Medical College, Beijing, China.
FAU - He, Yudi
AU  - He Y
AD  - Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Science and Peking Union Medical College, Beijing, China.
FAU - Fang, Song
AU  - Fang S
AD  - Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Science and Peking Union Medical College, Beijing, China.
FAU - Wang, Ou
AU  - Wang O
AD  - Key Laboratory of Endocrinology, Department of Endocrinology, National Commission 
      of Health, Peking Union Medical College Hospital, Chinese Academy of Medical 
      Science, Beijing, China.
FAU - Liao, Quan
AU  - Liao Q
AD  - Department of General Surgery, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science and Peking Union Medical College, Beijing, China.
FAU - Li, Jianchu
AU  - Li J
AD  - Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Science and Peking Union Medical College, Beijing, China.
FAU - Jiang, Yuxin
AU  - Jiang Y
AD  - Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Science and Peking Union Medical College, Beijing, China.
FAU - Zhu, Qingli
AU  - Zhu Q
AD  - Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Science and Peking Union Medical College, Beijing, China.
FAU - Liu, He
AU  - Liu H
AD  - Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Science and Peking Union Medical College, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230327
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
SB  - IM
MH  - Humans
MH  - *Hyperparathyroidism, Primary/complications/diagnostic imaging/surgery
MH  - Retrospective Studies
MH  - ROC Curve
MH  - Nomograms
PMC - PMC10083379
OTO - NOTNLM
OT  - multigland disease
OT  - nomogram
OT  - prediction
OT  - primary hyperparathyroidism
OT  - ultrasound
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/04/14 06:00
MHDA- 2023/04/14 06:42
PMCR- 2023/01/01
CRDT- 2023/04/13 01:58
PHST- 2022/11/02 00:00 [received]
PHST- 2023/01/26 00:00 [accepted]
PHST- 2023/04/14 06:42 [medline]
PHST- 2023/04/13 01:58 [entrez]
PHST- 2023/04/14 06:00 [pubmed]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2023.1088045 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2023 Mar 27;14:1088045. doi: 
      10.3389/fendo.2023.1088045. eCollection 2023.