用于识别恶性肿瘤体液性高钙血症患者的免疫反应性甲状旁腺激素相关蛋白的循环形式：与C末端（109-141）和N末端（1-86）区域特异性甲状旁腺激素相关蛋白放射免疫分析的比较研究

Circulating forms of immunoreactive parathyroid hormone-related protein for identifying patients with humoral hypercalcemia of malignancy: a comparative study with C-terminal(109-141)- and N-terminal(1-86)-region-specific PTHrP radioassay.

作者信息

Suehiro M, Murakami M, Fukuchi M

机构信息

Department of Nuclear Medicine, Hyogo College of Medicine, Japan.

出版信息

Ann Nucl Med. 1994 Nov;8(4):231-7. doi: 10.1007/BF03165025.

DOI:10.1007/BF03165025

PMID:7702967

Abstract

We evaluated the circulating forms of immunoreactive PTHrP in 115 healthy subjects and 122 patients with malignant diseases by using radioassay systems (RAS) specific for the C-terminal (109-141) fragment of PTHrP (C-RAS) and for the N-terminal(1-86) (N-RAS). PTHrP levels in healthy controls ranged from 1.5 to 38.2 (mean: 24.5) pmol/L with the C-RAS and from 0.9 to 2.5 (mean: 1.7) pmol/L with the N-RAS. The ratio of circulating N-terminal fragment (N) to C-terminal fragment (C) of PTHrP was calculated to be about 1: 14.4 in the healthy subjects. Of the 122 patients with malignant diseases, 40 (32.8%) had circulating PTHrP levels undetectable with the N-RAS, but only 11 (9.0%) patients had levels undetectable with the C-RAS. Of the former 122 patients, 41 (33.6%) had high PTHrP as determined with the C-RAS, and 10 (8.2%) had high PTHrP as determined with the N-RAS. The former of these included only 8 (19.5%) HHM patients, while the latter included 8 (80.0%) HHM patients. The circulating N to C ratio was about 1: 70.7 in the HHM patients. The N and C obtained with the different RASs showed a close correlation (r = 0.86). The values also showed a close correlation with serum Ca; r = 0.75 for C-RAS and r = 0.81 for N-RAS. In addition, the correlations between the PTHrP reading obtained with the different RASs and serum Cr were: r = 0.42 with C-RAS and r = 0.26 with N-RAS. The circulating form of immunoreactive PTHrP fragments is therefore comprised mainly of PTHrP(109-141). In contrast, circulating concentrations of the PTHrP(1-86) fragment are very low, but detection of the PTHrP(1-86) fragment with the N-RAS is a more useful indicator of HHM with fewer false positive results and is less likely to be influenced by renal function than the detection of the PTHrP(109-141) fragment with C-RAS.

摘要

我们使用针对甲状旁腺激素相关蛋白（PTHrP）C末端（109 - 141）片段的放射分析系统（C - RAS）和针对N末端（1 - 86）片段的放射分析系统（N - RAS），对115名健康受试者和122名恶性疾病患者体内免疫反应性PTHrP的循环形式进行了评估。健康对照组中，C - RAS检测的PTHrP水平范围为1.5至38.2（平均：24.5）pmol/L，N - RAS检测的水平范围为0.9至2.5（平均：1.7）pmol/L。健康受试者中，PTHrP循环N末端片段（N）与C末端片段（C）的比例经计算约为1 : 14.4。在122名恶性疾病患者中，40名（32.8%）患者的循环PTHrP水平用N - RAS检测不到，但只有11名（9.0%）患者的水平用C - RAS检测不到。在这122名患者中，41名（33.6%）用C - RAS检测显示PTHrP水平高，10名（8.2%）用N - RAS检测显示PTHrP水平高。前者中仅包括8名（19.5%）高钙血症危象（HHM）患者，而后者包括8名（80.0%）HHM患者。HHM患者中循环N与C的比例约为1 : 70.7。用不同RAS获得的N和C显示出密切相关性（r = 0.86）。这些值与血清钙也显示出密切相关性；C - RAS的r = 0.75，N - RAS的r = 0.81。此外，用不同RAS获得的PTHrP读数与血清肌酐之间的相关性为：C - RAS的r = 0.42，N - RAS的r = 0.26。因此，免疫反应性PTHrP片段的循环形式主要由PTHrP(109 - 141)组成。相比之下，PTHrP(1 - 86)片段的循环浓度非常低，但用N - RAS检测PTHrP(1 - 86)片段是HHM更有用的指标，假阳性结果更少，并且比用C - RAS检测PTHrP(109 - 141)片段受肾功能影响的可能性更小。