Coombes R S, Ward M K, Greenberg P B, Hillyard C J, Tulloch B R, Morrison R, Joplin G F
Cancer. 1976 Nov;38(5):2111-20. doi: 10.1002/1097-0142(197611)38:5<2111::aid-cncr2820380539>3.0.co;2-q.
Studies of calcium metabolism in 38 patients with cancer indicated that: 1) intestinal absorption of calcium was reduced in patients with skeletal metastases and in those with hypercalcemia; 2) calcium-47 space (a measurement of bone turnover rate) was high in the patients with skeletal metastases; 3) hypercalcemic patients had higher urinary and endogenous fecal excretion of calcium than those who were normocalcemic; 4) levels of plasma immunoreactive parathyroid hormone were similar in normo- and hypercalcemic patients, but the levels for a given serum calcium in malignant disease were lower than those in primary hyperparathyroidism; and 5) some patients had elevated calcitonin levels. Hypercalcemia complicating malignant disease is therefore not due to hyperabsorption or diminished excretion of calcium, and a low calcium diet is unlikely to benefit these patients. Measurement of 47Ca space could be of use in monitoring therapy of patients with skeletal metastases, and measurement of plasma parathyroid hormone could be useful in the differential diagnosis of hypercalcemia.
对38例癌症患者的钙代谢研究表明：1）有骨骼转移的患者和高钙血症患者的肠道钙吸收减少；2）有骨骼转移的患者钙-47空间（骨转换率的一种测量指标）较高；3）高钙血症患者的尿钙和内源性粪钙排泄高于血钙正常的患者；4）血钙正常和高钙血症患者的血浆免疫反应性甲状旁腺激素水平相似，但恶性疾病中给定血清钙水平下的该激素水平低于原发性甲状旁腺功能亢进症患者；5）一些患者的降钙素水平升高。因此，恶性疾病并发的高钙血症并非由于钙吸收过多或排泄减少，低钙饮食不太可能使这些患者受益。测量钙-47空间可用于监测骨骼转移患者的治疗，测量血浆甲状旁腺激素可有助于高钙血症的鉴别诊断。
