Sensitivity of fibroblast growth factor 23 measurements in tumor-induced osteomalacia
Sensitivity of fibroblast growth factor 23 measurements in tumor-induced osteomalacia
复制标题
DOI：
10.1210/jc.2005-2105
复制
发表时间：
2006-06-01
影响因子：
5.8
通讯作者：
Econs, Michael J.
中科院分区：
文献类型：
--
作者：
Imel, Erik A.;Peacock, Munro;Econs, Michael J.
内容：肿瘤诱导的骨软化症（TIO）是一种低磷酸盐血症、肾磷酸盐重吸收减少、正常或低血清1，25-二羟维生素D浓度、肌病和骨软化的副肿瘤综合征。成纤维细胞生长因子23（FGF 23）是一种磷酸尿蛋白过度表达的肿瘤，导致TIO和，至少部分，负责TIO.Objective的表现：本研究的目的是确定的敏感性FGF 23测量TIO。设计图：采用三种ELISA方法测定储存样本中的FGF 23浓度。设置：本研究在专科转诊中心进行。患者：22例疑似TIO患者，13例确诊肿瘤患者。干预措施：本研究中无干预措施。主要结局指标：FGF 23浓度是本研究的主要结局指标。结果：使用Immunotopics C末端测定法在22名TIO患者中的16名中检测到FGF 23浓度升高（灵敏度为73%），22名患者中有5名患者的免疫组化完整检测（灵敏度，23%），Kainos完整测定在22名患者中的19名中（灵敏度，86%）。在13例确诊肿瘤患者中，所有检测方法的灵敏度均较高：Immunotopics C-末端检测法为92%，Immunotopics Intact检测法为38%，Kainos检测法为100%.Conclusion：Kainos Intact检测法最敏感，其次是Immunotopics C-末端检测法。在一些TIO患者中发现的正常FGF 23浓度可能表明FGF 23与这些患者的低磷酸盐血症无关，或者某些肿瘤的FGF 23分泌部分响应于血清磷酸盐。正常的FGF 23浓度应与血清磷酸盐和1，25-二羟维生素D浓度相关。
Context: Tumor-induced osteomalacia (TIO) is a paraneoplastic syndrome of hypophosphatemia, decreased renal phosphate reabsorption, normal or low serum 1,25-dihydryxyvitamin-D concentration, myopathy, and osteomalacia. Fibroblast growth factor 23 (FGF23) is a phosphaturic protein overexpressed in tumors that cause TIO and is, at least partly, responsible for the manifestations of TIO.Objective: The objective of this study was to determine the sensitivity of FGF23 measurements in TIO. Design: FGF23 concentrations were measured on stored samples with three ELISAs.Setting: This study was conducted at subspecialty referral centers.Patients: Twenty-two patients with suspected TIO, 13 with confirmed tumors, were studied.Interventions: There were no interventions in this study.Main Outcome Measure: FGF23 concentration was the main outcome measure of this study.Results: Elevated FGF23 concentrations were detected using the Immunotopics C-terminal assay in 16 of 22 TIO patients ( for a sensitivity of 73%), the Immunotopics Intact assay in five of 22 patients ( sensitivity, 23%), and the Kainos Intact assay in 19 of 22 patients ( sensitivity, 86%). In the 13 patients with confirmed tumors, the sensitivity was higher with all assays: 92% for the Immunotopics C-terminal assay, 38% for the Immunotopics Intact assay, and 100% for the Kainos assay.Conclusion: The Kainos Intact assay was the most sensitive, followed by the Immunotopics C-terminal assay. The findings of normal FGF23 concentrations in some patients with TIO may indicate that FGF 23 is not responsible for the hypophosphatemia in these patients or that FGF23 secretion by some tumors is partially responsive to serum phosphate. Normal FGF23 concentrations should be interpreted in relation to the serum phosphate and 1,25-dihydryxyvitamin-D concentrations.