Predictive value of parathyroid hormone levels for permanent hypoparathyroidism at different time points after papillary thyroid cancer surgery

Abstract

Purpose To investigate the relationship between parathyroid hormone (PTH) levels on day 1 after radical thyroid surgery for papillary carcinoma and permanent hypoparathyroidism (PHPP) and the predictive value of the relationship between them. Methods Eighty patients with papillary thyroid cancer who underwent total thyroidectomy and lymph node dissection in the central area admitted to the General Surgery Department of Gansu Provincial People’s Hospital from January 2021 to January 2022 were collected and analyzed. Patients were divided into hypoparathyroidism and normal parathyroid groups according to whether PHPP occurred after surgery, and the correlation between parathyroid hormone (PTH) and serum calcium levels and permanent hypoparathyroidism (PHPP) on postoperative day 1 in both groups was analyzed using univariate and binary logistics regression. The area under the subject operating curve (ROC) was used to assess the predictive validity of PTH for the occurrence of PHPP in the postoperative period. Results PHPP occurred in 10 of the 80 patients with papillary thyroid cancer included, with an incidence of 12.5%; binary logistic regression analysis showed that PTH on a postoperative day 1 (OR = 14.534, 95% CI: 2.377 to 88.858, P = 0.004), was an independent predictive risk factor for the development of PHPP after surgery. The area under the curve (AUC) was 0.874 (95% CI: 0.79–0.958, P = 0.000) with a sensitivity of 71.4%, specificity of 100%, and Jorden index of 0.714, using PTH = 8.75ng/L on postoperative day 1 as the threshold value. Conclusions PTH levels on day 1 after total thyroid papillary carcinoma are strongly associated with permanent hypoparathyroidism and are an independent predictor of the development of PHPP.