Algorithm for topical diagnosis of parathyroid gland pathology using confocal laser microscopy
https://doi.org/10.58708/2074-2088.2024-1(31)-95-103
Abstract
The information content of the confocal laser microscopy (CLM) method for diagnosing of parathyroid gland pathology (adenoma/hyperplasia) in 30 patients who had the clinical and laboratory signs of hyperparathyroidism was analyzed. The pathology of the parathyroid gland was finally verified by histological method, based on the presence of follicle-like structures in the biopsy samples, the absence of stromal fat cells, and the absence of pronounced connective tissue septa. The sensitivity of CLM was assessed in comparison with the methods of ultrasound, CT scan, MRI, and scintigraphy with 99mTc-sestamibi. CLM showed the highest diagnostic accuracy for identifying parathyroid gland pathology with the establishment of a full set of pathognomonic criteria in 76,7% of cases (χ2=74,051, p<0,001). The advantage of CLM was proven by the absence of false negative results, while with ultrasound, scintigraphy, CT and MRI their frequency was 6,7%, 3,4%, 25,0% and 15,8%, respectively. An integrated approach to the instrumental diagnosis of parathyroid gland pathology for the purpose of subsequent surgical treatment is reflected in the developed algorithm. To ensure accurate topical diagnosis with determination of the morphological structure of pathological formations of the parathyroid gland using the CLM method during surgical intervention, a computer program «Hyperparathyroidism» has been developed (registration certificate № 1377, 31.12.2020).
About the Authors
A. V. Velichko
ГУ «РНПЦ радиационной медицины и экологии человека»
Belarus
Belarus
Y. I. Yarets
ГУ «РНПЦ радиационной медицины и экологии человека»
Belarus
Belarus
A. V. Rozhko
ГУ «РНПЦ радиационной медицины и экологии человека»
Belarus
Belarus
Z. A. Dundarov
УО «Гомельский государственный медицинский университет»
Belarus
Belarus
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For citations:
Velichko A.V., Yarets Y.I., Rozhko A.V., Dundarov Z.A. Algorithm for topical diagnosis of parathyroid gland pathology using confocal laser microscopy. Medical and Biological Problems of Life Activity. 2024;(1):95-103. (In Russ.) https://doi.org/10.58708/2074-2088.2024-1(31)-95-103
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