Uematsu T, Tsuchie K, Ukai K, Kimoto E, Funakawa T, Mizuno R
Department of Surgery, Meijo Hospital, Nagoya, Japan.
Int J Pancreatol. 1996 Apr;19(2):135-9. doi: 10.1007/BF02805227.
A rare case of granulocyte-colony stimulating factor (G-CSF) produced by carcinoma of the pancreas has been reported.
This is the first case showing high G-CSF concentration in the aspirated tumor fluid (mucin) at its early stage without leukocytosis.
The tumor, detected incidentally in a 64-yr-old male, was removed by a distal pancreatectomy. The mass was 7.0 x 6.5 x 4.5 cm, and was histologically diagnosed as cystadenocarcinoma with prominent sarcomatous transformation. It was classified as anaplastic carcinoma.
After 4 wk of resection, progressive leukocytosis was observed. Seven weeks after the operations, the peripheral leukocyte count increased to 126,000/mL. After 8 wk of resection, the patient died of recurrence. The serum G-CSF concentration was elevated after recurrence. The preserved mucin contained in the cystic components of the resected specimen had a G-CSF concentration higher than 2400 pg/mL. G-CSF is a known cytokine and an etiologic agent in paraneoplastic syndromes. An early diagnosis can, therefore, be made prior to the manifestation of clinical symptoms by the evaluation of the aspirated tumor fluid. This can lead to the prevention of the paraneoplastic syndrome with inhibitory cytokines in future.
本文报道了一例罕见的胰腺癌产生粒细胞集落刺激因子（G-CSF）的病例。
这是首例在早期吸出的肿瘤液（黏液）中G-CSF浓度高且无白细胞增多的病例。
该肿瘤在一名64岁男性中偶然发现，通过胰体尾切除术切除。肿块大小为7.0×6.5×4.5 cm，组织学诊断为伴有显著肉瘤样化生的囊腺癌。归类为间变性癌。
切除术后4周，观察到进行性白细胞增多。术后7周，外周白细胞计数增至126,000/mL。切除术后8周，患者死于复发。复发后血清G-CSF浓度升高。切除标本囊性成分中保存的黏液G-CSF浓度高于2400 pg/mL。G-CSF是一种已知的细胞因子，也是副肿瘤综合征的病因。因此，通过评估吸出的肿瘤液，可在临床症状出现之前做出早期诊断。这可能会在未来通过抑制性细胞因子预防副肿瘤综合征。
