BIOCHEMICAL EVALUATION OF PATIENTS WITH CANCER ASSOCIATED HYPER CALCEMIA EVIDENCE FOR HUMORAL AND NONHUMORAL GROUPS
BIOCHEMICAL EVALUATION OF PATIENTS WITH CANCER ASSOCIATED HYPER CALCEMIA EVIDENCE FOR HUMORAL AND NONHUMORAL GROUPS
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DOI：
10.1056/nejm198012113032401
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发表时间：
1980-01-01
影响因子：
158.5
通讯作者：
BROADUS A E
中科院分区：
文献类型：
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作者：
STEWART A F;HORST R;BROADUS A E
用4种区域特异性抗血清检测50例癌性高钙血症患者的肾源性cAMP、肾小管P阈值、空腹钙排泄、血浆1，25-二羟基维生素D和免疫反应性甲状旁腺激素。肾源性cAMP排泄增加41例，抑制9例(平均每100毫升肾小球滤液5.85对0.51nmol)。这些群体之间没有重叠。与15例原发性甲状旁腺功能亢进症患者相比，cAMP排泄量增加的患者肾小管P阈值降低，空腹钙排泄增加，1，25-二羟基维生素D显著减少(P<；0.001)，免疫反应性甲状旁腺激素水平降低。肾源性cAMP排泄增加可能是体液介导的癌症相关高钙血症的有用标志。这种类型的高钙血症很常见。引起这种综合征的体液因素不是天然的1-84甲状旁腺激素。癌症相关性高钙血症的不同亚型在生化上可与原发性甲状旁腺功能亢进症相区别。
In 50 consecutive patients with cancer-associated hypercalcemia, nephrogenous cAMP, tubular P threshold, fasting Ca excretion, plasma 1,25-dihydroxyvitamin D and immunoreactive parathyroid hormone were measured by 4 region-specific antiserums. Nephrogenous cAMP excretion was elevated in 41 patients and suppressed in 9 (means, 5.85 vs. 0.51 nmol per 100 ml of glomerular filtrate). There was no overlap between these groups. When compared with 15 patients with primary hyperparathyroidism, the group with increased cAMP excretion had similar reductions in tubular P threshold; higher fasting Ca excretion (P < 0.01); marked reductions in 1,25-dihydroxyvitamin D (P < 0.001); and lower levels of immunoreactive parathyroid hormone. Elevated excretion of nephrogenous cAMP may be a useful marker of humorally mediated cancer-associated hypercalcemia. This type of hypercalcemia is common. The humoral factor responsible for this syndrome is not native 1-84 parathyroid hormone. The various subtypes of cancer-associated hypercalcemia are biochemcially distinguishable from primary hyperparathyroidism.