METHODS: From January 1, 2013, to March 31, 2023, 230 PHPT patients, including 65 with NPHPT and 230 sex- and age-matched controls, were enrolled in this retrospective study. Differences between hypercalcaemic PHPT (HPHPT) and NPHPT and between them and their respective controls were analyzed. The diagnostic accuracy of the Ca∗Cl/P ratio, Ca/P ratio, Cl/P ratio and albumin-corrected calcium was assessed by the area under the receiver operating characteristic curve.
RESULTS: Compared with corresponding controls, NPHPT and HPHPT patients both had significantly higher Ca ∗ Cl/P ratios (271.64 ± 51.74 vs 192.71 ± 26; 419.91 ± 139.11 vs 199.14 ± 36.75, P < .001). In the overall cohort, the ROC-AUC of the Ca∗Cl/P ratio (0.964, 95% CI = 0.943-0.979) for diagnosis of PHPT patients was superior to albumin-corrected calcium (0.959, 95% CI = 0.934-0.973), the Ca/P ratio (0.956, 95% CI = 0.934-0.973), and the Cl/P ratio (0.923, 95% CI = 0.895-0.946). A Ca ∗ Cl/P ratio above 239.17 mmol/L, with sensitivity (0.952), specificity (0.922), PPV (0.924), NPV (0.951) and accuracy (0.937), can distinguish PHPT patients from healthy individuals. Furthermore, the Ca ∗ Cl/P ratio yielded a sensitivity of 0.831, specificity of 0.938, PPV of 0.931, NPV of 0.847 and accuracy of 0.885 for NPHPT.
CONCLUSIONS: The Ca∗Cl/P ratio provides excellent diagnostic power for diagnosis of PHPT, especially NPHPT.
方法:从2013年1月1日至2023年3月31日,230名PHPT患者,包括65名NPHPT和230名性别和年龄匹配的对照,参加了这项回顾性研究。分析了高钙血症性原发性甲状旁腺功能亢进(HPHPT)和NPHPT之间以及它们与各自对照之间的差异。Ca*Cl/P比值的诊断准确性,Ca/P比,通过受试者工作特征曲线下面积(ROC-AUC)评估Cl/P比率和白蛋白校正的钙。
结果:与相应的对照相比,NPHPT和HPHPT患者的Ca*Cl/P比值均显着较高(271.64±51.74vs.192.71±26;419.91±139.11vs.199.14±36.75,p<0.001)。在整个队列中,用于诊断PHPT患者的Ca*Cl/P比的ROC-AUC(0.964,95%CI=0.943-0.979)优于白蛋白校正钙(0.959,95%CI=0.934-0.973),钙/磷比值(0.956,95%CI=0.934-0.973),和Cl/P比(0.923,95%CI=0.895-0.946)。Ca*Cl/P比值大于239.17mmol/L,灵敏度(0.952),特异性(0.922),PPV(0.924),净现值(0.951)和准确度(0.937),可以区分PHPT患者和健康个体。此外,Ca*Cl/P比值对NPHPT的敏感性为0.831,特异性为0.938,PPV为0.931,NPV为0.847,准确性为0.885。
结论:Ca*Cl/P比值为PHPT的诊断提供了极好的诊断能力,尤其是NPHPT。