Blind E, Raue F, Meinel T, Pecherstorfer M, Räth U, Schmidt-Gayk H, Kohl B, Ziegler R
Abteilung Innere Medizin I, Medizinische Universitätsklinik Heidelberg.
Dtsch Med Wochenschr. 1993 Mar 12;118(10):330-5. doi: 10.1055/s-2008-1059333.
The clinical utility of measuring parathormone-related protein (PTHrP) was investigated in 94 patients (48 men, 46 women, mean age 56 [18-82] years) with tumour-associated hypercalcaemia, using a radioimmunoassay directed against the middle portion (53-84) of PTHrP (reference range < 5-21 pmol/l). Increased levels of the middle portion of PTHrP were found in 44 of the 73 patients (60%) with hypercalcaemia associated with solid tumours (median 49 [22-333] pmol/l). There was a positive correlation between the serum calcium concentration and the PTHrP (P = 0.018). The frequency of a raised PTHrP, indicating hormone-induced hypercalcaemia, was similar in patients with and without bone metastases (48% vs 66%). Elevated PTHrP was particularly frequent in patients with squamous cell carcinomas (17 out of 21; 81%), while PTHrP levels were normal in 18 out of the 21 patients with hypercalcaemia associated with haematological malignancies. PTHrP levels were normal in 37 out of 38 normocalcaemic tumour patients and in 30 out of 32 patients with primary hyperparathyroidism. Hypercalcaemia associated with benign disease was found in only one case, a female with marked benign breast hypertrophy.--The measurement of PTHrP allows the demonstration of a pathogenetic factor in tumour-associated hypercalcaemia, and differentiation from other causes of hypercalcaemia, in particular primary hyperparathyroidism.
采用针对甲状旁腺激素相关蛋白（PTHrP）中间部分（53 - 84）的放射免疫分析法，对94例肿瘤相关性高钙血症患者（48例男性，46例女性，平均年龄56岁[18 - 82岁]）进行了PTHrP检测临床效用的研究（参考范围<5 - 21 pmol/L）。在73例实体瘤相关性高钙血症患者中，44例（60%）患者的PTHrP中间部分水平升高（中位数49 [22 - 333] pmol/L）。血清钙浓度与PTHrP之间呈正相关（P = 0.018）。有无骨转移患者中提示激素诱导性高钙血症的PTHrP升高频率相似（48%对66%）。PTHrP升高在鳞状细胞癌患者中尤为常见（21例中有17例；81%），而在21例血液系统恶性肿瘤相关性高钙血症患者中，有18例PTHrP水平正常。38例血钙正常的肿瘤患者中有37例PTHrP水平正常，32例原发性甲状旁腺功能亢进患者中有30例PTHrP水平正常。仅1例良性疾病相关性高钙血症患者被发现，为一名患有明显良性乳腺肥大的女性。——PTHrP检测有助于明确肿瘤相关性高钙血症的致病因素，并与其他高钙血症原因相鉴别，尤其是原发性甲状旁腺功能亢进。
