Hutchesson A C, Dunne F, Bundred N J, Gee H, Ratcliffe W A
Department of Clinical Chemistry, Selly Oak Hospital, Birmingham, UK.
Postgrad Med J. 1993 Aug;69(814):640-2. doi: 10.1136/pgmj.69.814.640.
The tumour-derived factor PTH-related protein (PTHRP) is the primary humoral factor responsible for hypercalcaemia in patients with solid tumours. In a woman presenting with anaemia and hypercalcaemia, the finding of raised plasma PTHRP and undetectable serum PTH concentrations led to further investigations and the subsequent identification of a uterine tumour. No evidence of tumour spread was found at operation, and removal of the tumour resulted in normalization of both serum calcium and plasma PTHRP. Expression of PTHRP by the tumour was shown by immunohistochemistry and in situ hybridization. We conclude that the identification of an occult tumour in a patient with hypercalcaemia and raised plasma PTHRP provides evidence of the diagnostic utility of PTHRP immunoassays in the investigation of patients with hypercalcaemia and suspected malignancy.
肿瘤衍生因子甲状旁腺激素相关蛋白（PTHRP）是实体瘤患者高钙血症的主要体液因子。在一名出现贫血和高钙血症的女性患者中，血浆PTHRP升高而血清PTH浓度检测不到，这一发现促使进一步检查，并随后发现了子宫肿瘤。手术时未发现肿瘤扩散的证据，切除肿瘤后血清钙和血浆PTHRP均恢复正常。免疫组织化学和原位杂交显示肿瘤表达PTHRP。我们得出结论，在高钙血症和血浆PTHRP升高的患者中发现隐匿性肿瘤，为PTHRP免疫测定在高钙血症和疑似恶性肿瘤患者调查中的诊断效用提供了证据。
