成纤维细胞生长因子23
医学
低磷血症
骨软化症
背景(考古学)
恶性肿瘤
内科学
前列腺癌
胃肠病学
碱性磷酸酶
癌症
维生素D与神经学
甲状旁腺激素
钙
生物
生物化学
化学
酶
古生物学
作者
Farouk Bouraima,Vincent Sapin,Samy Kahouadji,Marie-Eva Pickering,Bruno Pereira,Damien Bouvier,Charlotte Oris
标识
DOI:10.1210/clinem/dgad297
摘要
Abstract Context Tumor-induced osteomalacia (TIO) due to fibroblast growth factor 23 (FGF23) overexpression is becoming recognized in patients with malignancy. The condition may be underdiagnosed, with a scarce medical literature. Objective To perform a meta-analysis of case reports to allow a better understanding of malignant TIO and its clinical implications. Methods Full texts were selected according to strict inclusion criteria. All case reports were included where patients had hypophosphatemia, malignant TIO, and FGF23 blood levels. Thirty-two of 275 eligible studies (n = 34 patients) met inclusion criteria. A list of desired data was extracted and graded for methodological quality. Results Prostate adenocarcinoma (n = 9) were the most tumors reported. Twenty-five of 34 patients had a metastatic disease and a poor clinical outcome was reported for 15 of 28 patients. The median levels of blood phosphate and C-terminal FGF23 (cFGF23) were 0.40 mmol/L and 788.5 RU/mL, respectively. For most of patients, blood PTH was elevated or within range, and calcitriol levels were inappropriately low or normal. Alkaline phosphatase concentrations were increased for 20 of 22 patients. The cFGF23 values were significantly higher for patients with a poor clinical outcome when compared to other patients (1685 vs 357.5 RU/mL). In case of prostate cancer, cFGF23 levels were significantly lower (429.4 RU/mL) than for other malignancies (1007.5 RU/mL). Conclusion We report for the first time a detailed description of the clinical and biological characteristics of malignant TIO. In this context, FGF23 blood measurement would be of value for the diagnostic workup, prognostication, and follow-up of patients.
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