오름창자암을 동반한 원발성 부갑상선기능항진증 2예 = Two Cases of Primary Hyperparathyroidism Associated with Colon Cancer

다국어 초록 (Multilingual Abstract)

Hypercalcemia is often observed in cancer patients secondary to parathyroid hormone (PTH) related peptide production. However, primary hyperparathyroidism and colon cancer rarely present simultaneously. Calcium is believed to have a chemopreventive effect against colorectal cancer because it reduces crypt cell hyperproliferation in both humans and in animals. There is evidence to suggest that the incidence of colorectal cancer in humans is reduced by high calcium intake. In patients with primary hyperparathyroidism, increased PTH activates 1,25(OH)2D and enhances calcium absorption in the gut. Consequently, the calcium level in the lumen is decreased, leading to an elevated risk of colorectal cancer. We report two patients with colon cancer and hypercalcemia secondary to primary hyperparathyroidism, along with a brief review of the literature.

참고문헌 (Reference)

1 Buras RR, "The effect of extracellular calcium on colonocytes: evidence for differential responsiveness based upon degree of cell differentiation" 28 : 245-262, 1995

2 Kawamura YJ, "Sigmoid colon cancer associated with primary hyperparathyroidism: Report of a Case" 29 : 789-790, 1999

3 Farr HW, "Primary hyperparathyroidism and cancer" 126 : 539-543, 1973

4 Gorham ED, "Optimal vitamin D status for colorectal cancer prevention: a quantitative meta analysis" 32 : 210-216, 2007

5 Stewart AF, "Hypercalcemia Associated with Cancer" 352 : 373-379, 2005

6 Kasper DL, "Harrison's Principles of Internal Medicine. 16th ed" McGraw-Hill 2252-, 2005

7 Milner JA, "Greenwald P: Molecular targets for nutrients involved with cancer prevention" 41 : 1-16, 2001

8 Lipkin M, "Dietary factors in human colorectal cancer" 19 : 545-586, 1999

9 Holt PR, "Comparison of calcium supplementation or low-fat dairy foods on epithelial-cell proliferation and differentiation" 41 : 150-155, 2001

10 Newmark HL, "Colon cancer and dietary fat, phosphate, and calcium: a hypothesis" 72 : 1323-1325, 1984

11 Sergio A, "Chemoprevention of colon cancer by calcium, vitamin D and folate: molecular mechanisms" 3 : 601-614, 2003

12 Kallay E, "Calcium-dependent c-myc proto-oncogene expression and proliferation of Caco-2 cells: a role for a luminal extracellular calcium-sensing receptor" 232 : 80-83, 1997

13 Nobre LC, "Calcium regulation of colonic crypt cell kinetics: evidence for a direct effect in mice" 109 : 498-504, 1995

14 Bilezikian JP, "Asymptomatic primary hyperparathyroidism" 350 : 1746-1751, 2004