Szymanski Jeffrey J, Otrock Zaher K, Patel Khushbu K, Scott Mitchell G
Department of Pathology and Immunology, Washington University, St Louis, MO, United States.
Department of Pathology and Immunology, Washington University, St Louis, MO, United States.
Clin Chim Acta. 2016 Jan 30;453:190-3. doi: 10.1016/j.cca.2015.12.017. Epub 2015 Dec 17.
Malignancy-associated hypercalcemia (MAHC) is the most common cause of hypercalcemia among hospitalized patients. MAHC can result from the production of parathyroid hormone related peptide (PTHrP) which is known as humoral hypercalcemia of malignancy (HHM). HHM is commonly thought to account for approximately 80% of MAHC.
We conducted a 12-year review of PTHrP testing at our institution to establish the prevalence of HHM among patients with MAHC.
A total of 524 PTHrP immunoassays were performed during the study period of which 470 tests qualified for inclusion in the analysis. Evidence of malignancy was found for 242 of 470 patients (51%). No etiology could be determined for 98 cases of MAHC (40%) and increased PTHrP contributed to 92 cases (38%) of MAHC. Age, race and gender were not associated with HHM. Increased PTHrP was observed at initial malignancy diagnosis in 20% of cases. PTHrP was never increased outside of the context of malignancy.
The prevalence of HHM among patients with MAHC is likely to be lower than previously described.
恶性肿瘤相关性高钙血症（MAHC）是住院患者高钙血症最常见的病因。MAHC可由甲状旁腺激素相关肽（PTHrP）产生所致，这被称为恶性肿瘤体液性高钙血症（HHM）。一般认为HHM约占MAHC的80%。
我们对本机构12年间的PTHrP检测进行了回顾，以确定MAHC患者中HHM的患病率。
在研究期间共进行了524次PTHrP免疫测定，其中470次检测符合纳入分析的条件。470例患者中有242例（51%）发现有恶性肿瘤证据。98例MAHC患者（40%）病因不明，PTHrP升高导致92例（38%）MAHC。年龄、种族和性别与HHM无关。20%的病例在初次诊断恶性肿瘤时观察到PTHrP升高。在恶性肿瘤之外，PTHrP从未升高。
MAHC患者中HHM的患病率可能低于先前描述的水平。
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