McLeod M K, Vinik A I
Department of Surgery, University of Michigan Medical School, Ann Arbor.
Surgery. 1992 May;111(5):484-8.
Hypercalcitoninemia in gastroenteropancreatic tumors associated with calcitonin immunoreactivity is rare.
We report here two patients in whom pancreatic neuroendocrine tumors both contained and secreted immunoreactive calcitonin. Both patients experienced elevated basal calcitonin immunoreactivity.
The peak responses of immunoreactive calcitonin occurred 5 minutes after pentagastrin administration in these two patients and were 30% and 180% above basal concentrations corresponding to peak increments of 0.39 and 8.78 ng/ml, respectively. The immunoreactive calcitonin response to pentagastrin in these two patients was not significantly different from that seen among five patients with medullary carcinoma of the thyroid gland.
It does not appear that immunoreactive calcitonin responses to pentagastrin stimulation will discriminate between patients with medullary carcinoma of the thyroid gland and those with nonfamilial, gastroenteropancreatic neuroendocrine tumors that express calcitonin immunoreactivity. In patients with secretory diarrhea and/or flushing, an elevated level of immunoreactive calcitonin, in the absence of a thyroid mass in the neck, may herald the presence of a gastroenteropancreatic neuroendocrine tumor.
与降钙素免疫反应性相关的胃肠胰肿瘤中的高降钙素血症较为罕见。
我们在此报告两名患者，其胰腺神经内分泌肿瘤均含有并分泌免疫反应性降钙素。两名患者的基础降钙素免疫反应性均升高。
这两名患者在给予五肽胃泌素后5分钟出现免疫反应性降钙素的峰值反应，分别比基础浓度高出30%和180%，相应的峰值增量分别为0.39和8.78 ng/ml。这两名患者对五肽胃泌素的免疫反应性降钙素反应与五名甲状腺髓样癌患者的反应无显著差异。
对五肽胃泌素刺激的免疫反应性降钙素反应似乎无法区分甲状腺髓样癌患者和表达降钙素免疫反应性的非家族性胃肠胰神经内分泌肿瘤患者。在有分泌性腹泻和/或潮红的患者中，在颈部无甲状腺肿块的情况下，免疫反应性降钙素水平升高可能预示着胃肠胰神经内分泌肿瘤的存在。
