Evaluation of the metabolism properties of choline kinase alpha in neoplasms of the parathyroid glands. A pilot study

BACKGROUND: Primary hyperparathyroidism (PHPT) is a widespread endocrine disease characterized by excessive production of parathyroid hormone (PTH) due to parathyroid gland hyperplasia (PGH) or tumor lesions (adenoma or cancer of the parathyroid gland (PG) in 80% and 1–5% of cases respectively). Choline kinase α–alpha (XKα) overexpression is described in tumors of different localization, but there is no data on its expression in PG tumors.

AIMS: To study the character of XKα expression in PG neoplasms and its relationship with clinical, laboratory, and visualization characteristics (positron emission tomography combined with computed tomography (PET/CT) with ¹⁸F–fluorocholine (¹⁸F–FC)).

MATERIALS AND METHODS: The material for the study was based on tissue samples from 10 patients of 34–70 years old (Me = 61.5; [48; 66]), with a laboratory–confirmed diagnosis of PHT. An immunohistochemical study (IHC) was carried out on materials from 2 patients with hyperplasia of the main cells, from 5 patients with adenoma of PG, from 1 patient with atypical adenoma and 1 with carcinoma of PG; in 1 case the metastasis of cancer of the neck with lymph node was examined.

RESULTS: The expression of XKα is spotted in all types of PG cells (chief cells: active and inactive forms), transitional forms between the chief cells and oxyphil; oxyphil cells, but it was most intense in active chief cells. The expression of XKα was observed in neoplasms of PG of various degrees of malignancy. In the most numerous group of PG formations with a favorable prognosis (11 samples from 7 patients), no statistically significant correlation (p> 0.05) was obtained between the intensity expression of the XKα, of the PTH and the proliferative activity index Ki–67, the level of radiopharmaceutical accumulation in PET/CT with ¹⁸F–FC (SUVmax) and laboratory data (PTH, Ca, Ca++).

CONCLUSIONS: In the majority of investigated cases, moderate and intensive expression of the XKα was detected in PG cells. A small amount of studied cases does not allow us to identify the connection between the intensity of XKα expression and the malignant potential for the formation of PG.

parathyroid gland, choline kinase alpha, primary hyperparathyroidism, atypical parathyroid adenoma, parathyroid carcinoma, 18F–Fluorocholine PET/CT

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