Bundred N J, Ratcliffe W A, Walker R A, Coley S, Morrison J M, Ratcliffe J G
Department of Surgery, Selly Oak Hospital, Birmingham.
BMJ. 1991 Dec 14;303(6816):1506-9. doi: 10.1136/bmj.303.6816.1506.
To see whether parathyroid hormone related protein has a humoral role in breast cancer.
Plasma concentrations and tumour expression of parathyroid hormone related protein were determined (by two site immunoradiometric assay and immunohistochemistry respectively) in women with breast cancer and related to the presence of bone metastases and serum calcium concentrations.
Plasma concentrations of parathyroid hormone related protein were measured in 57 women with early breast cancer without apparent bone metastases, 28 women with bone metastases, and 13 women with bone metastases and hypercalcaemia. Tissue positivity for parathyroid hormone related protein was determined retrospectively in 106 primary breast tumours from women without apparent bone metastases and 72 tumours from women with bone metastases, 25 of whom subsequently developed hypercalcaemia.
Plasma parathyroid hormone related protein concentrations were detectable (greater than 0.23 pmol/l) in 12 (92%) of the 13 hypercalcaemic patients with bone metastases compared with 10 (36%) of the 28 normocalcaemic patients with bone metastases and five (9%) of the 57 normocalcaemic patients without bone metastases. Parathyroid hormone related protein concentrations were significantly higher in hypercalcaemic than normocalcaemic patients with bone metastases. Tumour staining was positive for parathyroid hormone related protein in 22 (88%) of the 25 primary breast cancers from patients with bone metastases. Tumour staining was positive for parathyroid hormone related protein in 22 (88%) of the 25 primary breast cancers from patients with bone metastases who later developed hypercalcaemia compared with 25 (53%) of the 47 from women in this group who remained normocalcaemic and 55 (52%) of the 106 early breast cancers from women without known metastases.
Tumour derived parathyroid hormone related protein may have an important humoral role in hypercalcaemia associated with metastatic breast cancer.
探究甲状旁腺激素相关蛋白在乳腺癌中是否具有体液调节作用。
分别采用双位点免疫放射分析和免疫组织化学法，测定乳腺癌患者血浆中甲状旁腺激素相关蛋白的浓度及肿瘤组织中的表达情况，并分析其与骨转移及血清钙浓度的关系。
对57例无明显骨转移的早期乳腺癌女性患者、28例有骨转移的女性患者以及13例有骨转移且伴有高钙血症的女性患者，检测其血浆中甲状旁腺激素相关蛋白的浓度。回顾性分析106例无明显骨转移女性患者的原发性乳腺癌组织及72例有骨转移女性患者的肿瘤组织中甲状旁腺激素相关蛋白的组织阳性情况，其中25例有骨转移且伴有高钙血症的患者后续出现高钙血症。
13例伴有高钙血症的骨转移患者中，12例（92%）血浆甲状旁腺激素相关蛋白浓度可检测到（大于0.23 pmol/l）；28例血钙正常的骨转移患者中，10例（36%）可检测到；57例血钙正常且无骨转移的患者中，5例（9%）可检测到。伴有高钙血症的骨转移患者甲状旁腺激素相关蛋白浓度显著高于血钙正常的骨转移患者。25例有骨转移且后续出现高钙血症的患者中，22例（88%）原发性乳腺癌肿瘤染色显示甲状旁腺激素相关蛋白呈阳性；该组中47例血钙正常的患者，25例（53%）肿瘤染色呈阳性；106例无已知转移的早期乳腺癌女性患者中，55例（52%）肿瘤染色呈阳性。
肿瘤来源的甲状旁腺激素相关蛋白可能在转移性乳腺癌相关的高钙血症中发挥重要的体液调节作用。
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