Kuwano H, Baba H, Matsuda H, Ohno S, Mori M, Kanematsu T, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
J Surg Oncol. 1989 Dec;42(4):229-33. doi: 10.1002/jso.2930420406.
A review of 208 cases of surgically treated squamous cell carcinoma of the esophagus revealed 16 (7.7%) with hypercalcemia. There was no evidence of bone metastases in 13 (6.3%) of the patients with hypercalcemia. Pathogenesis of this hypercalcemia without bone metastases was suggested to be multifactorial. Anastomotic leakage and malnutrition because of fasting were the most possible causes of mild hypercalcemia, and moderate to severe hypercalcemia was thought to be due to subclinical and clinical recurrence of the tumor, probably with PTH-like hormonal activity. Overall survival rates in the groups with and without hypercalcemia were 18.2 and 61.7% at the 12th postoperative month and 9.1 and 37.8% at the 24th month, respectively. Thus hypercalcemia is a significant prognostic factor linked to an unfavorable clinical course even in patients with no evidence of bone metastases.
对208例接受手术治疗的食管鳞状细胞癌病例进行回顾发现，16例（7.7%）出现高钙血症。13例（6.3%）高钙血症患者无骨转移证据。这种无骨转移的高钙血症的发病机制被认为是多因素的。吻合口漏和禁食导致的营养不良是轻度高钙血症最可能的原因，中度至重度高钙血症被认为是肿瘤亚临床和临床复发所致，可能具有甲状旁腺激素样活性。术后第12个月，有高钙血症组和无高钙血症组的总生存率分别为18.2%和61.7%；术后第24个月，分别为9.1%和37.8%。因此，即使在无骨转移证据的患者中，高钙血症也是一个与不良临床病程相关的重要预后因素。
