Sato T, Omura M, Saito J, Hirasawa A, Kakuta Y, Wakabayashi Y, Nishikawa T
Department of Hematology, Yokohama Rosai Hospital for Labour Welfare Corporation, Kanagawa, Japan.
Thyroid. 2000 Dec;10(12):1113-8. doi: 10.1089/thy.2000.10.1113.
Cancers associated with marked neutrophilia are relatively rare. We report here two cases of anaplastic thyroid carcinoma associated with neutrophilia. We measured the concentrations of granulocyte colony-stimulating factor (G-CSF), macrophage CSF (M-CSF), granulocyte-macrophage CSF (GM-CSF), interleukin-1alpha (IL-1alpha), IL-1beta, IL-6, and tumor necrosis factor-alpha (TNF-alpha) in sera, pleural effusion, cyst fluid of the thyroid carcinoma region, or culture supernatants of carcinoma cells. Maximum levels of elevated white blood cell counts reached 106.1 x 10(9)/L (neutrophils 103.0 x 10(9)/L) in case 1 and 62.3 x 10(9)/L (neutrophils 57.9 x 10(9)/L) in case 2. Acute-phase reactants were elevated to various degrees, and hypercalcemia was found in both cases. IL-6, G-CSF, and M-CSF seemed to play the principal roles in neutrophilia in case 1, and the elevated levels of IL-6 and M-CSF seemed to mainly contribute to neutrophilia in case 2. Immunohistochemical staining revealed that carcinoma cells themselves produce IL-6 regardless of the types of carcinoma cells. To our knowledge, this is the first report describing the contribution of M-CSF to neutrophilia in patients with thyroid carcinoma.
与明显嗜中性粒细胞增多相关的癌症相对罕见。我们在此报告两例与嗜中性粒细胞增多相关的间变性甲状腺癌。我们测量了血清、胸腔积液、甲状腺癌区域的囊液或癌细胞培养上清液中粒细胞集落刺激因子（G-CSF）、巨噬细胞集落刺激因子（M-CSF）、粒细胞巨噬细胞集落刺激因子（GM-CSF）、白细胞介素-1α（IL-1α）、IL-1β、IL-6和肿瘤坏死因子-α（TNF-α）的浓度。病例1中白细胞计数最高升至106.1×10⁹/L（中性粒细胞103.0×10⁹/L），病例2中升至62.3×10⁹/L（中性粒细胞57.9×10⁹/L）。急性期反应物不同程度升高，两例均发现高钙血症。在病例1中，IL-6、G-CSF和M-CSF似乎在嗜中性粒细胞增多中起主要作用，在病例2中，IL-6和M-CSF水平升高似乎是嗜中性粒细胞增多的主要原因。免疫组化染色显示，癌细胞自身可产生IL-6，与癌细胞类型无关。据我们所知，这是第一份描述M-CSF在甲状腺癌患者嗜中性粒细胞增多中作用的报告。
