去分化子宫内膜癌中甲状旁腺激素的异位产生及甲状旁腺激素相关蛋白的产生导致严重高钙血症。

Ectopic Production of Parathyroid Hormone and Production of Parathyroid Hormone-related Protein in Dedifferentiated Endometrial Carcinoma Induced Severe Hypercalcemia.

作者信息

Ogino Takeru, Watanabe Hirofumi, Yamazaki Shoko, Kurosawa Megumi, Kobayashi Akiko, Imai Naofumi, Taguchi Takahiro, Umezu Hajime, Aida Ryo, Watanabe Kazuki, Otsuka Tadashi, Kabasawa Hideyuki, Kaseda Ryohei, Yamamoto Suguru, Yoshihara Kosuke, Goto Shin, Narita Ichiei

机构信息

Division of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Japan.

Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Japan.

出版信息

Intern Med. 2025 Apr 1;64(7):1053-1059. doi: 10.2169/internalmedicine.3899-24. Epub 2024 Sep 4.

DOI:10.2169/internalmedicine.3899-24

PMID:39231677

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12021519/

Abstract

Hypercalcemia is a significant complication in cancer patients, primarily caused by parathyroid hormone-related peptide (PTHrP) and, rarely, by parathyroid hormone (PTH) production from tumors. We report a case of severe hypercalcemia in a woman with uterine cancer who exhibited elevated PTH and PTHrP levels. Surgical intervention revealed dedifferentiated endometrial carcinoma. Postoperatively, PTH and PTHrP levels normalized but subsequently increased due to metastases. A molecular analysis confirmed the expression of the PTH gene and protein within the tumor, indicating ectopic PTH production. In diagnosing and treating cancers, it is necessary to consider not only PTHrP production but also ectopic PTH production.

摘要

高钙血症是癌症患者的一种重要并发症，主要由甲状旁腺激素相关肽（PTHrP）引起，很少由肿瘤产生甲状旁腺激素（PTH）所致。我们报告一例子宫癌女性患者出现严重高钙血症，其甲状旁腺激素（PTH）和甲状旁腺激素相关肽（PTHrP）水平升高。手术干预显示为去分化子宫内膜癌。术后，PTH和PTHrP水平恢复正常，但随后因转移而升高。分子分析证实肿瘤内甲状旁腺激素（PTH）基因和蛋白的表达，表明存在异位甲状旁腺激素产生。在癌症的诊断和治疗中，不仅要考虑PTHrP的产生，还要考虑异位PTH的产生。