Kikumori T, Ichikawa T, Inaishi T, et al. - Given that the aspartate aminotransferase (AST)/lactate dehydrogenase (LD) ratio in tissue suspension may accurately distinguish normal parathyroid tissue from other tissues, researchers tested the assumption that this ratio may also be applied to distinguish hyperfunctioning parathyroid tissue (HPT) from other tissues. Twenty-two patients who had parathyroidectomy for primary hyperparathyroidism (benign, 21; malignant, 1) from July 2018 to October 2019 were prospectively analyzed. A total of 27 specimens were examined. The AST/LD ratio of benign HPT was significantly greater than that of other tissues. This approach could be a new adjunct for HPT intraoperative differentiation with an precision and turnaround time comparable to those of frozen sections, reduced cost, and no need for dedicated pathological personnel. Additionally, this approach may improve the success rate of treatment in settings with limited medical resources.