Månsson B, Ahrén B, Nobin A, Böttcher G, Sundler F
Department of Surgery, Lund University, Sweden.
Surgery. 1990 Feb;107(2):182-6.
We examined immunocytochemically the occurrence of the three peptides calcitonin, calcitonin gene-related peptide (CGRP), and gastrin-releasing peptide (GRP) in medullary carcinoma of the thyroid. We also sought to determine whether the plasma levels of these peptides were increased when stimulated with calcium and pentagastrin in familial medullary carcinoma of the thyroid (MCT). The tumor tissue from all 17 cases examined was found to exhibit calcitonin and CGRP immunoreactivity, and in 15 of the 17 cases the tumor tissue also contained GRP immunoreactivity. In 7 of the cases selected at random, an intravenous injection of calcium carbonate (2 mg/kg body weight) and pentagastrin (0.6 microgram/kg body weight) produced marked elevation in plasma levels of calcitonin but did not significantly alter the plasma levels of CGRP or GRP. We conclude that most MCT tumors contain CGRP and GRP immunoreactive cells but that the plasma levels of CGRP and GRP are not altered on stimulation. This finding is clearly in contrast to the markedly elevated calcitonin levels. Hence, determination of plasma calcitonin levels still seems to be the most appropriate diagnostic test for MCT.
我们采用免疫细胞化学方法检测了甲状腺髓样癌中降钙素、降钙素基因相关肽（CGRP）和胃泌素释放肽（GRP）这三种肽的表达情况。我们还试图确定在家族性甲状腺髓样癌（MCT）中，用钙和五肽胃泌素刺激后，这些肽的血浆水平是否会升高。在所检测的17例病例的肿瘤组织中，均发现有降钙素和CGRP免疫反应性，17例中有15例肿瘤组织还含有GRP免疫反应性。在随机选取的7例病例中，静脉注射碳酸钙（2mg/kg体重）和五肽胃泌素（0.6μg/kg体重）可使降钙素的血浆水平显著升高，但对CGRP或GRP的血浆水平无明显影响。我们得出结论，大多数MCT肿瘤含有CGRP和GRP免疫反应性细胞，但刺激后CGRP和GRP的血浆水平未发生改变。这一发现与降钙素水平明显升高形成鲜明对比。因此，测定血浆降钙素水平似乎仍是MCT最适宜的诊断检测方法。
