Hypercalcemia associated with parathyroid hormone-related protein at the terminal stage of uncomplicated squamous cell carcinoma in the head and neck region.
BACKGROUND
Parathyroid hormone-related protein (PTHrP) is mainly responsible for hypercalcemia in squamous cell carcinomas (SCCs).


METHODS
We retrospectively checked the appearance of hypercalcemia among 33 patients who died with head and neck SCC. Serum concentrations of C-terminal region of PTHrP (C-PTHrP) were measured in 15 of them. The intracellular PTHrP expression was immunohistochemically stained in 42 SCC sections obtained from the 33 before the appearance of hypercalcemia.


RESULTS
Hypercalcemia appeared in 24 of the 33, and increased serum C-PTHrP levels were confirmed in 11 of 12 hypercalcemic patients. PTHrP was identified in all SCC sections, and a stronger intensity than in normal squamous epithelia was observed in 50% of those obtained within 1 year before the onset of hypercalcemia.


CONCLUSIONS
A high incidence of PTHrP-induced hypercalcemia was shown among patients dying with head and neck SCCs. The intracellular increase in PTHrP might be observed preceding hypercalcemia.
Fujikawa
Megumi
M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan. memi@intmed2.med.kyusyu-u.ac.jp
Takata
Yutaka
Y
Okamura
Ken
K
Nakagawa
Mizuho
M
Tateishi
Akira
A
Kurokawa
Hideo
H
Sato
Kaori
K
Fukuda
Jinichi
J
Kajiyama
Minoru
M
Fujishima
Masatoshi
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology*; D006801:Humans; D006934:Hypercalcemia / Q000150:complications / Q000473:pathology*; D007150:Immunohistochemistry; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D044162:Parathyroid Hormone-Related Protein; D011237:Predictive Value of Tests; D011336:Probability; D011506:Proteins / Q000032:analysis*; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D019452:Terminally Ill
D015415:Biomarkers; C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins