Stewart A F, Romero R, Schwartz P E, Kohorn E I, Broadus A E
Cancer. 1982 Jun 1;49(11):2389-94. doi: 10.1002/1097-0142(19820601)49:11<2389::aid-cncr2820491128>3.0.co;2-w.
Fasting calcium excretion, renal phosphorus threshold, plasma 1,25 dihydroxyvitamin D, immunoreactive PTH, nephrogenous cyclic AMP excretion, and tumor burden were assessed in nine patients with gynecologic neoplasms and hypercalcemia. Gynecologic neoplasms were responsible for hypercalcemia in seven of 34 (20.5%) consecutive patients with malignancy-associated hypercalcemia. The tumor burden in each patient was large. Three of four endometrial carcinomas contained squamous elements. All patients displayed biochemical evidence of nonparathyroid humorally mediated hypercalcemia (bone resorption). Treatment of hypercalcemia did not appear to diminish production of the humoral calcemic factor but eradication of tumor eliminated biochemical evidence of the humoral syndrome. It can be concluded that (1) gynecologic neoplasms are a frequent cause of malignancy-associated hypercalcemia, (2) humoral mechanisms appeared to be responsible for the hypercalcemia in 100% of the patients in this series, (3) squamous features occur with unexpected frequency in hypercalcemic endometrial carcinoma, (4) the presence of hypercalcemia connotes a large tumor burden, and (5) treatment directed at the neoplasm (but not treatment directed at hypercalcemia) may eliminate evidence of ectopic calcemic hormone production.
对9例患有妇科肿瘤并伴有高钙血症的患者进行了空腹钙排泄、肾磷阈值、血浆1,25 - 二羟维生素D、免疫反应性甲状旁腺激素、肾源性环磷酸腺苷排泄及肿瘤负荷的评估。在34例连续性恶性肿瘤相关性高钙血症患者中，有7例（20.5%）的高钙血症由妇科肿瘤引起。每位患者的肿瘤负荷都很大。4例子宫内膜癌中有3例含有鳞状成分。所有患者均表现出非甲状旁腺激素介导的高钙血症（骨吸收）的生化证据。高钙血症的治疗似乎并未减少体液性钙调节因子的产生，但肿瘤根除后消除了体液综合征的生化证据。可以得出以下结论：（1）妇科肿瘤是恶性肿瘤相关性高钙血症的常见病因；（2）在本系列研究中，100%的患者高钙血症似乎由体液机制引起；（3）高钙血症型子宫内膜癌中鳞状特征出现的频率出乎意料；（4）高钙血症的存在意味着肿瘤负荷大；（5）针对肿瘤的治疗（而非针对高钙血症的治疗）可能消除异位钙调节激素产生的证据。
