Association Between Parathyroid Hormone-Related Peptide Levels and Mortality in Patients With Malignancy

IF 3.7 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Ai Kimura MD, Kazuhiko Kato MD, Akio Nakashima MD, PhD, Yukio Maruyama MD, PhD, Ichiro Ohkido MD, PhD, Yoichi Miyazaki MD, PhD, Takashi Yokoo MD, PhD
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Abstract

Objective

Hypercalcemia of malignancy is a risk factor for mortality in patients with malignancies. Although the parathyroid hormone-related protein (PTHrP) secreted by tumor cells induces hypercalcemia, the association between serum PTHrP levels and mortality remains unclear. This study aimed to investigate the association between serum PTHrP levels and mortality in patients with malignancies.

Methods

We included patients with hypercalcemia (>10 mg/dL) and elevated PTHrP levels (>1.1 pmol/L) and analyzed mortality (overall survival after cancer diagnosis, PTHrP measurement, and 5-year survival rate). Moreover, using Cox proportional hazard model analysis, we investigated the impact of PTHrP levels on survival prognosis, assessing whether this effect varied depending on calcium concentration.

Results

We analyzed the data of 183 patients. The median PTHrP level, corrected calcium level, and age were 5.5 (3.0-10.6) pmol/L, 12.5 (11.5-13.4) mg/dl, and 70 (61-76) years, respectively. PTHrP was significantly and linearly associated with serum calcium levels (correlation coefficient, 0.06; 95% CI: 0.039-0.081, t: 5.69; P < .001). The group with the highest PTHrP levels had significantly worse survival rates than the group with the lowest PTHrP levels (hazard ratio: 1.68, 95% CI 1.03-2.77, P = .038).

Conclusion

This study showed an association between PTHrP and mortality in patients with malignancy after adjusting for serum calcium levels.
甲状旁腺激素相关肽水平与恶性肿瘤患者死亡率之间的关系。
目的恶性肿瘤高钙血症是导致恶性肿瘤患者死亡的一个危险因素。虽然肿瘤细胞分泌的甲状旁腺激素相关蛋白(PTHrP)会诱发高钙血症,但血清PTHrP水平与死亡率之间的关系仍不清楚。方法我们纳入了高钙血症(>10 mg/dL)和 PTHrP 水平升高(>1.0 pmol/L)的患者,并分析了死亡率(癌症诊断后的总生存率、PTHrP 测量值和 5 年生存率)。此外,我们还使用 Cox 比例危险模型分析法研究了 PTHrP 水平对生存预后的影响,并评估了这种影响是否因钙浓度而异。中位 PTHrP 水平、校正钙水平和年龄分别为 5.5(3.0-10.6)pmol/L、12.5(11.5-13.4)mg/dl 和 70(61-76)岁。PTHrP 与血清钙水平呈显著线性相关(相关系数:0.06;95% 置信区间:0.039-0.081;t:5.69;P<0.001)。PTHrP水平最高组的生存率明显低于PTHrP水平最低组(危险比:1.68,95%置信区间:1.03-2.77,P=0.038)。
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来源期刊
Endocrine Practice
Endocrine Practice ENDOCRINOLOGY & METABOLISM-
CiteScore
7.60
自引率
2.40%
发文量
546
审稿时长
41 days
期刊介绍: Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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