PTH、Ca、P在肿瘤骨转移判断中的变化分析

An Analysis of Changes of PTH,Ca,and P in the Determination of Tumor Bone Metastasis

目的观察肿瘤患者血清甲状旁腺素(PTH)、钙(Ca)、磷(P)水平,探讨肿瘤患者PTH分泌情况及其对钙磷代谢的调节作用。方法选择2018年1月至2021年4月在我院明确诊断为肿瘤的111例患者为研究对象,其中骨转移者36例,对其血清PTH、Ca、P水平进行回顾性分析。另外纳入48例健康体检者作为对照组。比较各组患者血清PTH、Ca、P水平。结果血清PTH水平在骨转移组、非骨转移组、对照组间有差异(P=0.044),其中骨转移组血清PTH高于对照组和非骨转移组。血清总Ca、校正Ca、P水平在三组间有差异(P<0.001,P<0.001,P=0.001),其中非骨转移组患者血清总Ca、校正Ca低于对照组,非骨转移组患者血清P水平较对照组升高(P=0.003)。血清校正Ca、P水平在PTH升高组、PTH正常组、PTH降低组间差异有统计学意义(P=0.024,P=0.049)。血清校正Ca在PTH正常组高于降低组(P=0.019),血清P在PTH正常组低于降低组(P=0.049)。结论肿瘤患者血清PTH水平升高,对于肿瘤骨转移的判断有一定的临床参考意义。部分肿瘤患者分泌过多的PTH,但不一定影响血钙水平,应综合分析PTH升高而血钙正常的情况。

Objective The objective of the study was to investigate the secretion of PTH and its regulation of calcium and phosphorus metabolism by observing serum levels of parathyroid hormone(PTH),calcium(Ca)and phosphorus(P).Methods A total of 111 patients who were diagnosed with tumors in Shijitan Hospital from January,2018 to April,2021 were selected as the research subjects,including 36 patients with bone metastases.Serum PTH,Ca,P levels of all the subjects were analyzed retrospectively.Another 48 healthy patients were selected as the control group.Levels of PTH,Ca,P in each group were compared.Results The serum PTH had significant different among the bone metastasis group,non-bone metastasis group,and the normal control group(P=0.044).The PTH level in the bone metastasis group was higher than that in the control group and the non-bone metastasis group.Serum total Ca,corrected Ca and P levels were significantly different among the three groups(P<0.001,P<0.001,P=0.001).Among them,the total serum Ca and corrected Ca levels in the non-bone metastasis group were lower than those in the control group,andthe serum P level in the non-bone metastasis group was higher than that in the control group(P=0.003).There was a statistically significant difference in serum corrected Ca and P levels among the PTH elevated group,the PTH normal group,and the PTH reduced group(P=0.024,P=0.049).The serum corrected Ca level in the PTH normal group is higher than that in the PTH reduce group(P=0.019),and the P level in the PTH normal group is lower than that in the PTH reduce group(P=0.049).Conclusion The increase of PTH level in tumor patients has a certain clinical reference value in the diagnosis of tumor bone metastasis.Some tumor patients can secrete high volume of parathyroid hormone,but it does not necessarily affect the blood calcium level.A situation of elevated PTH levels and normal serum calcium levels should be comprehensively analyzed.