Abstract
Background
Parathyroid gland (PG) is an endocrine organ which may display different immunohistochemical stainings with chief cells and oxyphilic cells in normal as well as hyperplasic/tumoral lesions.
Purpose
In this study, we aimed to identify the demographic properties and diagnostic value of the GATA3 antibody, which is a transcription factor in addition to PTH, and of PAX-8 (monoclonal and polyclonal) antibody.
Methods
We have analyzed in detail the cellular components and staining intensities of 46 adenomas all of which contained parathyroid rims, 12 hyperplasia and 5 adjacent non-neoplastic thyroidectomy materials (63 patients, 114 tissues).
Results
While no staining was identified in the thyroid tissue, cytoplasmic PTH immunoreactivity was observed in all (100%) normal parathyroid tissues, rim of PGs and hyperplasia, and in 43/46 cases (93.4%) of adenomas. Adenoma and hyperplasia were less stained than normal PG (p < 0.05). We detected GATA3 staining in all cases except for the thyroid (100%). Weak positivity (1+) was most apparent in adenoma cases (p < 0.05). Monoclonal PAX-8 immunoreactivity was not identified in any normal parathyroid tissue and rim of PG but positive immunoreactivity was detected in 83.3% of hyperplasia cases (10/12), 84.8% of adenoma (39/46) and 100% of thyroid tissues (5/5) (p < 0.05). However, polyclonal PAX-8 immunoreactivity was detected in one normal parathyroid tissue (1/5) and seven (7/46) rim of PGs. In cases of hyperplasia and adenoma, positive immunoreactivity was 75% (9/12) and 74% (34/46), respectively.
Conclusion
In conclusion, we have observed that PTH and GATA3 constitute a much more reliable and sensitive marker for parathyroid and are stained less in adenomas. While monoclonal PAX-8 (MRQ-50) never stains normal parathyroid and rim of PGs, it may help in the differential diagnosis of proliferated parathyroid lesions as a considerably sensitive and relatively specific marker by staining hyperplasic parathyroid, adenomas and the thyroid.
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Acknowledgments
We would like to thank our surgeons, endocrinologists, radiologists, biochemists and nuclear medicine specialists, who work together as an endocrine unit in our hospital.
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Ethical Statement Institutional REB, IEC approvals were obtained. The study was approved by the Clinical Trial Ethics Committee (Dr. Sadi Konuk Hospital, number 2020/132).
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Altınay, S., Erözgür, B., Dural, A.C. et al. Monoclonal/polyclonal PAX-8, PTH and GATA3 immunohistochemistry in parathyroid lesions. J Endocrinol Invest 44, 1997–2008 (2021). https://doi.org/10.1007/s40618-021-01518-3
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DOI: https://doi.org/10.1007/s40618-021-01518-3