Study on serum levels of vitamin D and calcium and expression of tissue calcium-sensing receptor in the breast cancers / 中国医师杂志

ObjectiveTo explore the relationship among 25-hydroxyvitamin D,serum calcium,calcium-sensing receptor,and breast cancer. Methods The expressions of calcium-sensing receptor (CaSR) in primary breast cancer,breast benign tumors,and normal breast tissue beside tumors were determined by immunohistochemistry S-P method as well as the concentration of serum 25 (OH) D and serum calcium in breast cancer and breast benign tumors by Enzyme-linked immunosorbent assay (ELISA),Tribromoarsenazo Ⅲ method.ResultsSerum 25 (OH) D level of breast cancer was significantly lower than the breast benign tumors [ (34.13 ± 14.14) nmol/L vs (50.29 ± 25.65 ) nmol/L,t =2.870,P =0.001 ].Serum level of 25 ( OH ) D in lymph node metastasis positive patient was lower than that in negative group [ (30.8 ± 9.71 ) nmol/L vs (43.7 ± 23.59) nmol/L,t =2.467,P =0.021 ].The positive expression of CaSR in breast cancer(88.9％ )was higher than breast benign tumors(60％,x2 =6.717,P ＜ 0.01 ) and normal breast tissue beside tumors (60％,x2 =5.628,P ＜ 0.05 ).ConclusionsConcentration of serum 25 (OH)D and expression of calcium-sensing receptor in the tissues may be associated with occurrence,development and prognosis of breast cancer.

Hiperparatireoidismo secundário: fatores prognósticos de recidiva atribuída ao implante após paratireoidectomia total e auto-implante / Secondary hyperparathyroidism: prognostic factors of graft-dependent recurrence after total parathyroidectomy and parathyroid autotransplantation

Nos casos de hiperparatireoidismo secundário onde não é possível o tratamento clínico, é indicada a paratireoidectomia. No Serviço de Cirurgia de Cabeça e Pescoço do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, o tipo de cirurgia utilizada é a paratireoidectomia total com auto-implante de paratireóide em membro superior. Nesses casos, ao contrário da paratireoidectomia total, pode haver recidiva do hiperparatireoidismo no sítio do implante, com sintomas sistêmicos e com necessidade de intervenção para retirada do tecido hiperplásico. Já na paratireoidectomia total, há hipoparatireoidismo definitivo e risco de doença óssea adinâmica. O presente estudo tem como escopo avaliar os pacientes submetidos a paratireoidectomia com implante e esclarecer se há fatores clínicos e de imunohistoquímica que possam indicar antes da cirurgia algum risco de recidiva no implante.

When clinical treatment of secondary hyperparathyroidism fails, parathyroidectomy is mandatory. Total parathyroidectomy and immediate parathyroid autotransplantation in the forearm is the treatment of choice at Head and Neck Surgery of Hospital das Clínicas of University of São Paulo Medical School. In this cases, recurrent hyperparathyroidism may be caused by hyperplastic graft tissue. Without autotransplantation, adinamic bone disease may occur. The present study seek to evaluate patients submitted to total parathyroidectomy and autotransplantation and try to clarify clinical or immunohistochemical.