恶性肿瘤中的高钙血症
Hypercalcemia in malignancy.
作者信息
Strewler G J, Nissenson R A
机构信息
Endocrine Unit, Veterans Administration Medical Center, San Francisco, CA 94121.
出版信息
West J Med. 1990 Dec;153(6):635-40.
Abstract
The pathogenesis of hypercalcemia in malignancy has been enigmatic until recent years. Since the realization in 1980 that bioassays for parathyroid hormone detected a cross-reacting substance in malignancy, progress has been remarkably rapid. A parathyroid hormone-related protein was purified and identified by molecular cloning as a 141-amino acid peptide with limited homology to parathyroid hormone itself. Nonetheless, both peptides activate the parathyroid hormone receptor to produce hypercalcemia. It is now clear that the parathyroid hormone-related protein is the cause of hypercalcemia in most solid tumors, particularly squamous and renal carcinomas. New assays for the hormone as well as the related peptide have greatly simplified the differential diagnosis of hypercalcemia. At the same time, new agents for the treatment of hypercalcemia are becoming available, most notably the bisphosphonate drugs.
摘要
直到近年来，恶性肿瘤中高钙血症的发病机制一直是个谜。自1980年认识到甲状旁腺激素生物测定法在恶性肿瘤中检测到一种交叉反应物质以来，进展非常迅速。一种甲状旁腺激素相关蛋白被纯化，并通过分子克隆鉴定为一种与甲状旁腺激素本身同源性有限的141个氨基酸的肽。尽管如此，这两种肽都能激活甲状旁腺激素受体，导致高钙血症。现在很清楚，甲状旁腺激素相关蛋白是大多数实体瘤，特别是鳞状细胞癌和肾癌中高钙血症的病因。针对该激素以及相关肽的新检测方法极大地简化了高钙血症的鉴别诊断。与此同时，治疗高钙血症的新药物也越来越多，最显著的是双膦酸盐药物。
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