- 期刊
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Lung Cancer with Hypercalcemia: Case Analysis and Literature Review
肺癌合併高鈣血症：病例分析與文獻回顧
摘要
高鈣血症是腫瘤附屬徵候群的一種，可發生於肺癌患者其疾病病程中的任何時期。然而肺癌患者合併高鈣血症的發生率與盛行率並未完全清楚；合併高鈣血症的肺癌患者，其臨床表徵與腫瘤特徵也不完全清楚。因此本研究最主要的目的就是探討肺癌合併高鈣血症的發生率與盛行率，並確認合併高鈣血症的肺癌患者，其臨床表徵與腫瘤特徵。從1989年11月至1998年11月，137位原發性肺癌患中有7位合併有高鈣血症。其臨床表徵，腫瘤特徵（腫瘤大小、組織形態與轉移部位）及實驗室檢查（鈣離子濃度、白血球數目與中性球百分比）均為研究重點。結果顯示，肺癌合併高鈣血症的發生率為3.7%，而盛行率為5.1%。7位患者中4位為男性，3位為女性，平均年齡為70歲。其中4位（57.1%）患者為鱗狀上皮癌，3位（42.9%）為腺癌。5位患者其高鈣血症與肺癌診斷同時發生，而另2位患者其高鈣血症分別於肺癌診斷後15及24個月後發生。6位（85.7%）患者有白血球增多與中性球增多現象。患者的腫瘤大小介於4.5×4.5至13×13公分之間。5位（71.4%）患者有遠端轉移。發生高鈣血症後患者的平均存活期其65天。總而言之，肺癌合併高鈣血症的發生率與盛行率並不高。鱗狀上皮癌為肺癌合併高鈣血症最常見的組織形態。白血球增多與中性球增多常發生於肺癌合併高鈣血症患者。肺癌合併高鈣血症患者通常已經是疾病晚期，腫瘤相對較大，且患者存活期短。
並列摘要
Paraneoplastic hypercalcemia may occur in patients with lung cancer at some time during the course of their disease. However, the frequency of its occurrence in such patients is unknown. The relationship of hypercalcemia between tumor characteristics and clinical features of such patients is also uncertain. The aims of this study are to determine the frequency of hypercalcemia in patients with lung cancer, and to delineate the relationship of hypercalcemia and tumor characteristics and clinical features of patients were included for study. In each patient, laboratory examinations including serum calcium level, WBC count, percentage of neutrophils were done. Characteristics information of tumor including tumor size, histological type, and metastatic status, as well as clinical features of the patients were recorded. Seven of the 137 patients were hypercalcemia. The incidence and prevalence of hypercacemia was 3.7% and 5.1%, respectively. Of these 7 patients, 4 were males and 3 were females; age ranged from 59 to 80 years, with a mean of 70 years. Four (57.1%) patients were squamous cell carcinoma, and 3 (42.9%) patients were adenocarcinoma. Five patients had hypercalcemia at the time of diagnosis of lung cancer. Two had hypercalcemia 15 and 24 months after the diagnosis of lung cancer. Six (85.7%) patients were found to have leukocytosis and neutrophilia. The tumor sizes were ranged from 4.5X4.5 cm to 13X13 cm. Five (71.4%) patients also had distant metastases. The median survival after development of hypercalcemia was 65 days, with a range of 22 to 161 days. The result of this study suggested that the incidence and prevalence of hypercalcemia in patients with lung cnacer is relatively low; squamous cell carcinoma is the most frequent type of lung cancer in patients with hypercalcemia; leukocytosis and neutrophilia are frequently occurred in patients with lung cancer and hypercalcemia; patients with lung cancer and hypercalcemia usually have and advanced disease, a large tumor bulk, and a shortened survival.