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(American Journal of Pathology. 2004;165:565-576.)
© 2004 American Society for Investigative Pathology

Molecular Classification of Parathyroid Neoplasia by Gene Expression Profiling

Carl Morrison*{dagger}{ddagger}§, William Farrar¶||, Jeff Kneile§, Nita Williams*{dagger}{ddagger}, Yiwen Liu-Stratton**, Alan Bakaletz{dagger}{dagger}, Micheala A. Aldred*{dagger}{ddagger}{ddagger} and Charis Eng*{dagger}{ddagger}

From the Human Cancer Genetics Program;* the Clinical Cancer Genetics Program;{dagger} the Comprehensive Cancer Center; the Department of Internal Medicine,{ddagger} Division of Human Genetics; the Departments of Pathology§ and Surgery,|| Division of Surgical Oncology; the Microarray Core Facility** and Bioinformatics Core Facility,{dagger}{dagger} Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio; and, the Division of Medical Genetics,{ddagger}{ddagger} University of Leicester, Leicester, United Kingdom

The current classification of sporadic parathyroid neoplasia, specifically the distinction of adenoma from multiple gland neoplasia (double adenoma and nonfamilial primary hyperplasia) is problematic and results in a relatively high rate of clinical error. Oligonucleotide microarrays (Affymetrix U133A) were used to evaluate parathyroid samples from 61 patients; 35 adenomas, 10 nonfamilial multiple gland neoplasia, 3 familial primary hyperplasia, 8 renal-induced hyperplasia, and 5 from patients without parathyroid disease (normals). A multiclass comparison using supervised clustering identified distinct gene signatures for each class of parathyroid samples. We developed a predictor model that correctly identified 34 of 35 cases of adenoma, 9 of 10 cases of nonfamilial multiple gland neoplasia, and identified a minimum set of 11 genes for the distinction of adenoma versus multiple gland neoplasia. All methods of unsupervised clustering showed two related but different types of parathyroid adenomas that we have arbitrarily designated as type 1 and type 2 adenomas. Multiple gland parathyroid neoplasia, which represents either synchronous or asynchronous autonomous growth in two, three, or all four parathyroid glands, is a distinct molecular entity and does not represent the molecular pathogenesis of adenoma occurring in multiple glands.




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