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Albumin-corrected serum calcium and serum parathyroid hormone-related polypeptide determined by enzyme-linked immunosorbent assay in cirrhotic patients with hepatocellular carcinoma – a pilot study

The Egyptian Journal of Internal Medicine volume 31, pages 896–901 (2019)Cite this article

Abstract

Context

Parathyroid hormone-related peptide (PTHrP) is produced by many malignant tumors. It is responsible for most cases of hypercalcemia in patients with malignancy. Few published studies shed light on the relation between serum calcium levels and serum PTHrP levels in cirrhotic patients with hepatocellular carcinoma (HCC).

Aim

The aim of the current work was to evaluate serum PTHrP in cirrhotic patients with HCC and a possible correlation between serum PTHrP levels and albumin-corrected serum calcium levels in these patients.

Patients and methods

This is a cross-sectional study. The study included 35 cirrhotic patients with HCC (diagnosed depending upon α-fetoprotein and abdominal imaging studies). Data about their serum albumin and albumin-corrected serum calcium levels were collected. Sera of the studied patients were collected for determination of PTHrP levels by enzyme-linked immunosorbent assay (ELISA). Numerical data were summarized in the form of mean±SD. Strength of association between variables was tested using Pearson correlation coefficient.

Results

Approximately 8.6% of studied patients were hypercalcemic, and no statistically significant positive correlation was detected between serum PTHrP determined by ELISA and albumin-corrected serum calcium in these patients.

Conclusion

Approximately 8.6% of studied cirrhotic patients with HCC were hypercalcemic. NO statistically significant positive correlation was detected between serum PTHrP determined by ELISA and albumin-corrected serum calcium in these patients. Studies involving a larger number of patients could clarify the exact role of PTHrP in the development of hypercalcemia in cirrhotic patients with HCC.

References

  1. El-Serag HB. Hepatocellular carcinoma. N Engl J Med 2011; 365:1118–1127.

    Article  CAS  Google Scholar 

  2. Trevisani F, Frigerio M, Santi V, Grignas-chi A, Bernardi M. Hepatocellular carcinomainnon-cirrhotic liver: areappraisal. Dig Liver Dis 2010; 42:341–347.

    Article  Google Scholar 

  3. Giannini EG, Marenco S, Bruzzone L, Savarino V, Farinati F, et al. Hepatocellular carcinoma in patients without cirrhosis in Italy. Dig Liver Dis 2013; 45:164–169.

    Article  Google Scholar 

  4. Saleem N, Kotecha T, Tariq M, Senussi N. Hypercalcemia as a paraneoplastic syndrome in association with hepatocellular carcinoma. Open J Clin Med Case Rep 2016; 1149:1–4.

    Google Scholar 

  5. Oldenburg WA, Van Heerden JA, Sizemore GW. Hypercalcemia and primary hepatic tumors. Arch Surg 1982; 117:1363–1366.

    Article  CAS  Google Scholar 

  6. Attali P, Houssin D, Roche A. Hepatic arterial embolization for malignant hypercalcemia in hepatocellular carcinoma. Dig Dis Sci 1984; 29:446–449.

    Article  Google Scholar 

  7. Ghobrial MW, George J, Mannam S, Henien SR. Severe hypercalcemia as an initial presenting manifestation of hepatocellular carcinoma. Can J Gastroenterol 2002; 16:607–609.

    Article  Google Scholar 

  8. Chang PE, Ong WC, Lui HF, Tan CK. Epidemiology and prognosis of paraneoplastic syndromes in hepatocellular carcinoma. ISRN Oncol 2013; 2013:684026.

    PubMed  PubMed Central  Google Scholar 

  9. Mallory TB. Case records of the Massachusetts General Hospital: Case 27461. N Engl J Med 1941; 225:789–791.

    Article  Google Scholar 

  10. Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, et al. EASL Panel of Experts on HCC. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver J Hepatol 2001; 35:421–430.

    CAS  Google Scholar 

  11. Mayo Clinic Medical Laboratories. https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/81774. [Accessed on15th August 2019].

  12. Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973; 60:646–649.

    Article  CAS  Google Scholar 

  13. Qu Q, Wang S, Chen S, Zhou L, Rui JA. Prognostic role and significance of paraneoplastic syndromes in hepatocellular carcinoma. Am Surg 2014; 80:191–196.

    Article  Google Scholar 

  14. Papworth K, Grankvist K, Ljungberg B, Rasmuson T. Parathyroid hormone-related protein and serum calcium in patients with renal cell carcinoma. Tumour Biol 2005; 26:201–206.

    Article  CAS  Google Scholar 

  15. Deans C, Wigmore S, Paterson-Brown S, Black J, Ross J, Fearon KC. Serum parathyroid hormone-related peptide is associated with systemic inflammation and adverse prognosis in gastroesophageal carcinoma. Cancer 2005; 103:1810–1818.

    Article  CAS  Google Scholar 

  16. Mirrakhimov AE. Hypercalcemia of malignancy: an update on pathogenesis and management. N Am J Med Sci 2015; 7:483–493.

    Article  Google Scholar 

  17. Clines GA, Guise TA. Hypercalcaemia of malignancy and basic research on mechanisms responsible for osteolytic and osteoblastic metastasis to bone. Endocr Relat Cancer 2005; 12:549–583.

    Article  CAS  Google Scholar 

  18. Seyberth HW, Segre GV, Morgan JL, Sweetman BJ, Potts JT Jr, et al. Prostaglandins as mediators of hypercalcemia associated with certain types of cancer. N Engl J Med 1975; 293:1278–1283.

    Article  CAS  Google Scholar 

  19. Okazaki R. Cytokines in bone diseases. Cytokines and malignancy-associated hypercalcemia. Clin Calcium 2010; 20:1497–1502.

    CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Departmentof Internal Medicine, Faculty of Medicine, Kasr AlAiny Hospital, Cairo University, Cairo, Egypt

    Ragai M. F. R. Fouda MD, MRCP

  2. Departmentof Clinical Pathology, Faculty of Medicine, Kasr AlAiny Hospital, Cairo University, Cairo, Egypt

    Nora M. Selim

  3. Department of Internal Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

    Rania E. Sheir

  4. Department of Internal Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt

    Ahmed A. Hammad

Authors
  1. Ragai M. F. R. Fouda MD, MRCP
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  2. Rania E. Sheir
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  3. Nora M. Selim
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  4. Ahmed A. Hammad
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Corresponding author

Correspondence to Ragai M. F. R. Fouda MD, MRCP.

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Fouda, R.M.F.R., Sheir, R.E., Selim, N.M. et al. Albumin-corrected serum calcium and serum parathyroid hormone-related polypeptide determined by enzyme-linked immunosorbent assay in cirrhotic patients with hepatocellular carcinoma – a pilot study. Egypt J Intern Med 31, 896–901 (2019). https://doi.org/10.4103/ejim.ejim_121_19

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  • DOI: https://doi.org/10.4103/ejim.ejim_121_19

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