Shane J M, Naftolin F
Am J Obstet Gynecol. 1975 Jan 1;121(1):133-43. doi: 10.1016/0002-9378(75)90991-6.
Increasing numbers of endocrine active tumors are being reported. The production of hormonal substances not generally associated with the tissues involved may directly or indirectly concern the gynecologist. Identification of these occurrences may be important in the diagnosis of occult neoplasms or obscure tumor effects. In addition, observation of the level of aberrant hormone secretion may be important therapeutic and prognostic measure. Detection may result from the investigation of apparent inappropriate and endocrine syndromes or routine screening in cases of known tumors. Proof of the actual production of hormone by the tumors and complete identification of the material in question generally requires extensive biologic, chemical, physical, and immunologic investigation. The most likely mechanisms for aberrant hormone production by tumors are derepression of the genome or the occurrence of chance biosynthetic anomalies coincident with neoplastic nuclear alterations. Endocrine active substances of interest to the gynecologist produced under these circumstances include gonadotropin, lactogens, thyrotropins, and adrenocortico-tropin, as well as calcium-mobilizing and erythropoietic substances.
据报道,内分泌活性肿瘤的数量在不断增加。产生通常与受累组织无关的激素物质可能直接或间接地涉及妇科医生。识别这些情况对于隐匿性肿瘤或不明肿瘤效应的诊断可能很重要。此外,观察异常激素分泌水平可能是重要的治疗和预后措施。检测可能源于对明显不适当的内分泌综合征的调查,或已知肿瘤病例的常规筛查。肿瘤实际产生激素的证据以及对相关物质的完全鉴定通常需要广泛的生物学、化学、物理和免疫学研究。肿瘤产生异常激素的最可能机制是基因组去抑制或与肿瘤细胞核改变同时发生的偶然生物合成异常。在这些情况下,妇科医生感兴趣的内分泌活性物质包括促性腺激素、催乳素、促甲状腺素和促肾上腺皮质激素,以及钙动员物质和促红细胞生成物质。