Naafs M A, Hackeng W H, Koorevaar G, Silberbusch J
Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
Bone Miner. 1988 Jul;4(3):289-98.
The renal response to calcium infusion was compared in ten normocalcaemic patients with squamous cell cancer and in ten normocalcaemic patients with adenocarcinoma. Both groups were comparable with regard to tumour load, renal function, magnesium and 25-hydroxyvitamin D levels. After injection of 3 mg elementary Ca/kg BW nephrogenous cAMP excretion fell significantly in the group of adenocarcinoma patients (1.74 +/- 1.14 nmol/dl GF vs. 2.81 +/- 1.39 nmol/dl GF; P less than 0.01) and TmPO4/GFR rose significantly at 60 and 120 min. No fall in NcAMP excretion was observed in the group of squamous cell cancer patients (2.18 +/- 0.84 vs. 2.24 +/- 0.84 nmol/dl GF; NS) and TmPO4/GFR remained unchanged. Three of ten patients with squamous cell cancer showed a paradoxical rise in NcAMP excretion following calcium administration. The other seven patients with squamous cell cancer showed a decline in NcAMP excretion (delta NcAMP) which was significantly less than in the ten patients with adenocarcinoma (0.52 +/- 0.16 vs. 1.23 +/- 0.74 nmol/dl GF; P less than 0.05). Increased phosphaturia was observed in three of ten patients with squamous cell cancer after calcium was administered. This also occurred in the presence as well as in the absence of a paradoxical activation of the adenylate cyclase system. It is concluded that the abnormal NcAMP response to calcium-infusion in normocalcaemic squamous cell cancer patients might be due to the presence of a non-suppressible PTH-like substance in these patients.
对10名血钙正常的鳞状细胞癌患者和10名血钙正常的腺癌患者的肾脏对钙输注的反应进行了比较。两组在肿瘤负荷、肾功能、镁和25-羟基维生素D水平方面具有可比性。在注射3mg元素钙/kg体重后，腺癌患者组的肾源性环磷酸腺苷（NcAMP）排泄量显著下降（1.74±1.14nmol/dl肾小球滤过率（GF）对2.81±1.39nmol/dl GF；P<0.01），且在60分钟和120分钟时TmPO4/GFR显著升高。鳞状细胞癌患者组未观察到NcAMP排泄量下降（2.18±0.84对2.24±0.84nmol/dl GF；无显著性差异），且TmPO4/GFR保持不变。10名鳞状细胞癌患者中有3名在补钙后NcAMP排泄量出现反常升高。其他7名鳞状细胞癌患者的NcAMP排泄量下降（NcAMP变化量），显著低于10名腺癌患者（0.52±0.16对1.23±0.74nmol/dl GF；P<0.05）。10名鳞状细胞癌患者中有3名在补钙后出现了磷尿增加。这在腺苷酸环化酶系统存在反常激活以及不存在反常激活的情况下均会发生。结论是，血钙正常的鳞状细胞癌患者对钙输注的异常NcAMP反应可能是由于这些患者中存在一种不可抑制的甲状旁腺激素样物质。
