口腔へん平上皮癌における高カルシウム血症の検討 血清ＰＴＨｒＰ値について

Abstract

Malignancy-associated hypercalcemia (MAH) often occurs in patients with squamous cell carcinoma of the lung, esophagus, oral cavity, and pharynx as well as those with other histopathologic malignancies, such as breast cancer, renal cell carcinoma and adult T-cell leukemia. We often encounter MAH in patients with terminal oral cancer. Parathyroid hormone related peptide (PTHrP) is considered the most likely cause of MAH. The aim of our study was to investigate whether the serum concentration of PTHrP rises in patients with oral cancer. We measured serum PTHrP (C-terminal) in 84 serum samples obtained from 70 patients with oral squamous cell carcinoma and 7 serum samples from 7 patients with hepatocellular carcinoma (HCC). Serum Ca, alkaline phosphatase, and PTHrP (C-terminal) were higher in patients with terminal oral squamous cell carcinoma than in those with oral squamous cell carcinoma before treatment. The incidence of patients who had high levels of serum Ca, alkaline phosphatase, and PTHrP (C-terminal) was higher in patients with oral squamous cell carcinoma patients than in those with HCC. Among patients with oral squamous cell carcinoma before treatment, some had high PTHrP (Cterminal) concentrations and others did not. All patients with T 1 and stage I oral squamous cell carcinoma had normal serum PTHrP (C-terminal) levels. In patients with oral squamous cell carcinoma, the serum PTHrP (C-terminal) level correlated with the serum Ca and alkaline phosphatase levels. These results indicate that PTHrP is responsible for humoral hypercalcemia of malignancy in oral squamous cell carcinoma. We conclude that assessment of serum PTHrP concentrations may facilitate the early diagnosis of hypercalcemia of malignancy in oral squamous cell carcinoma.