Baylin S B, Weisburger W R, Eggleston J C, Mendelsohn G, Beaven M A, Abeloff M D, Ettinger D S
N Engl J Med. 1978 Jul 20;299(3):105-10. doi: 10.1056/NEJM197807202990301.
To ascertain whether the content of endocrine markers is constant in small-cell carcinoma of the lung, levels of three markers of medullary thyroid carcinoma were studied in this tumor. Histaminase was increased in six of six primary tumors (three to 14,000 times), L-dopa decarboxylase in four of six (six to 30 times), and calcitonin in one of one (eight times) over levels in adjacent lung. Marker levels in mediastinal metastases reflected those in primary tumors in four of five patients. However, in four of seven, multiple hepatic metastases contained low to absent levels despite simultaneously high values in chest lesions. Immunohistochemical studies of histaminase revealed that within each primary tumor different cells contained different amounts of the enzyme. Since marker content varied between tumor cells, between primary tumors and between metastases in individual patients we conclude that circulating levels of these three markers cannot be expected necessarily to mirror tumor burden in patients with small-cell lung tumors.
为确定肺小细胞癌中内分泌标志物的含量是否恒定，研究了该肿瘤中三种甲状腺髓样癌标志物的水平。与相邻肺组织相比，六种原发性肿瘤中的六种组胺酶水平升高（3至14000倍），六种中的四种L-多巴脱羧酶水平升高（6至30倍），一例降钙素水平升高（8倍）。五例患者中有四例纵隔转移灶中的标志物水平反映了原发性肿瘤中的水平。然而，七例中有四例，尽管胸部病变中同时存在高值，但多个肝转移灶中的标志物水平较低或不存在。组胺酶的免疫组织化学研究表明，在每个原发性肿瘤内，不同细胞所含的酶量不同。由于标志物含量在肿瘤细胞之间、原发性肿瘤之间以及个体患者的转移灶之间存在差异，我们得出结论，这三种标志物的循环水平不一定能反映肺小细胞肿瘤患者的肿瘤负荷。
