Preoperative CALLY Index for Identifying Atypical Parathyroid Tumors
Authors' conclusion
The preoperative CALLY index may serve as a simple and accessible adjunctive marker for identifying patients with an increased likelihood of atypical parathyroid pathology before surgery. Its clinical value appears to lie primarily in preoperative APT-TPA discrimination and risk stratification rather than prediction of postoperative recurrence. Prospective multicenter validation is warranted before routine clinical implementation.
Study context
- Population
- Adults undergoing parathyroidectomy for primary hyperparathyroidism, June 2020–December 2025matched cohort
- Participants
- 206 adults
- Comparison
- APT vs typical parathyroid adenomas (TPA)
- APTn = 50
- TPAn = 156reference
- Outcome
- Histopathologically confirmed APT; diagnostic accuracy of the CALLY index by ROC analysis
Methodological detailsobservational, matched analytical case-control design, age- and sex-matched
- Observational
- Matched analytical case-control design
- Age- and sex-matched
Main finding
As reported in the abstract
CALLY index · preoperative
APT
3.11
median
TPA
10.55
median
P < 0.001
- AUC for APT-TPA differentiation
- 0.941
- Sensitivity at cutoff ≤ 5.73
- 88.0%
- Specificity at cutoff ≤ 5.73
- 86.5%
- NPV at cutoff ≤ 5.73
- 95.7%
Observational data: associations, not effects.
Further findings
Independent predictors of APT (multivariable logistic regression)
- Low CALLY, OR
- 37.29; p < 0.001
- Low CALLY outperformed serum calcium, PTH and tumor diameter
Original publication
Preoperative CALLY Index for Identifying Atypical Parathyroid Tumors. Clin Endocrinol (Oxf). Published 9 June 2026. doi:10.
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