Radványi Ildikó, Csikós Agnes, Balogh Sándor
Pécsi Tudományegyetem, Általános Orvostudományi Kar Családorvostani Intézet, Palliatív Tanszék Pécs Rákóczi u. 2. 7623.
Orv Hetil. 2013 Sep 1;154(35):1367-73. doi: 10.1556/OH.2013.29665.
Cancer-related hypercalcaemia is one of the most common life-threatening metabolic disorders. It occurs in 20% to 30% of patients with cancer during the course of the disease, which depends on tumour type, too. There are two types of cancer-related hypercalcemia: humoral hypercalcemia and local osteolytic hypercalcaemia. Malignant hypercalcaemia is mediated by several circulating factors secreted by malignant cells. The biological actions of these factors are primarily stimulation of osteoclasts to resorb bone and, secondly, stimulation of calcium reabsorption at the renal tubules resulting in an elevation of serum calcium level. Diagnosis of hypercalcaemia is relatively difficult due to the non-specific clinical signs as well as the underlying malignancy and the side-effects of palliative medical treatment. Consequently, cancer-related hypercalcaemia is underdiagnosed quite often. Unrecognised malignant hypercalcaemia can lead to death. Nowadays 90% of hypercalcaemia can be treated with administration of intravenous saline containing fluids and bisphosphonates. Literature data suggest that hypercalcaemia is treated in less than 40% of hospitalized patients properly due to diagnostic errors and mismanagement.
癌症相关的高钙血症是最常见的危及生命的代谢紊乱之一。在病程中，20%至30%的癌症患者会出现这种情况，这也取决于肿瘤类型。癌症相关的高钙血症有两种类型：体液性高钙血症和局部溶骨性高钙血症。恶性高钙血症由恶性细胞分泌的几种循环因子介导。这些因子的生物学作用主要是刺激破骨细胞吸收骨质，其次是刺激肾小管对钙的重吸收，导致血清钙水平升高。由于非特异性临床症状以及潜在的恶性肿瘤和姑息性治疗的副作用，高钙血症的诊断相对困难。因此，癌症相关的高钙血症常常诊断不足。未被识别的恶性高钙血症可导致死亡。如今，90%的高钙血症可以通过静脉输注含液体的生理盐水和双膦酸盐进行治疗。文献数据表明，由于诊断错误和管理不当，不到40%的住院患者的高钙血症得到了正确治疗。
