Kamata Toshiko, Koh Eitetsu, Masunaga Atsuko, Okabayashi Asako, Hasegawa Mizue, Katsura Hideki, Hiroshima Kenzo, Sekine Yasuo
Department of Thoracic Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo-shi, Chiba, Japan.
Department of Pathology, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo-shi, Chiba, Japan.
J Thorac Dis. 2018 May;10(5):E372-E377. doi: 10.21037/jtd.2018.04.96.
Parathyroid hormone-related protein (PTHrP), which is released in the presence of malignant disease, is associated with hypercalcemia. Complete resection of the tumor in such patients is rarely performed because of their poor general condition. We herein report a case of lung cancer associated with PTHrP in a patient whose condition dramatically improved after surgery. We also review the literature on the benefits of various surgical options. Although only a few cases of complete resection in such patients have been reported, the mental and physical condition of the patients improved postoperatively and the median survival time was longer than 12 months. A poor general status is frequently considered a contraindication for surgery, even in a palliative setting; however, we conclude that resection of lung cancer may lead to improved symptom control and survival when the patient's condition is induced by hypercalcemia secondary to PTHrP secretion from the tumor.
甲状旁腺激素相关蛋白（PTHrP）在恶性疾病情况下释放，与高钙血症相关。由于此类患者一般状况较差，很少进行肿瘤的完全切除。我们在此报告一例与PTHrP相关的肺癌患者，其术后病情显著改善。我们还回顾了有关各种手术选择益处的文献。尽管此类患者完全切除的病例报道较少，但患者术后精神和身体状况有所改善，中位生存时间超过12个月。即使在姑息治疗中，一般状况差也常被视为手术禁忌证；然而，我们得出结论，当患者状况由肿瘤分泌PTHrP继发高钙血症引起时，切除肺癌可能会改善症状控制并延长生存期。
