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Background  Parathyroid carcinoma (PC), often misdiagnosed as a parathyroid adenoma (PA), is prone to local relapse due to the initial surgery being restricted to parathyroid lesions instead of en bloc resection of parathyroid lesions with negative incision margins. However, it is very challenging to distinguish PC from PA preoperatively; hence, this study investigated an effective biomarker for increasing accuracy in PC diagnosis.    Method  First, the differentially expressed circular RNAs between three PC tissues and three PA tissues were screened by high-throughput circular RNA sequencing, and the expression of  hsa_circ_0005729  was verified by qRT-PCR in 14 patients with PC and 40 patients with PA. Secondly, the receiver operating characteristic curve and the area under the curve (AUC) were used to analyze the diagnostic efficiency of  hsa_circ_0005729  in PC by combining with laboratory data. Thirdly,  RNF138 mRNA, the corresponding linear transcript of  hsa_circ_0005729,  was measured, and the relationship between  hsa_circ_0005729  and  RNF138  mRNA was analyzed in patients with PA and patients with PC.    Results   Hsa_circ_0005729  expression was significantly higher in patients with PC than in patients with PA. Serum calcium ( P   = 0.045), alkaline phosphatase (ALP) ( P   = 0.048), and creatinine levels ( P   = 0.036) were significantly higher in patients with PC than in patients with PA. The AUC increased to 0.86 when  hsa_circ_0005729  combined with serum calcium, creatinine, and ALP. In addition,  hsa_circ_0005729  was positively correlated with  RNF138  mRNA in patients with PA but not in patients with PC.    Conclusion  The novel circular RNA  hsa_circ_0005729  was found to have a higher expression in patients with PC, indicating its usefulness for distinguishing PC from PA.

Hsa_circ_0005729 enhances accuracy in diagnosing parathyroid carcinoma