肿瘤样钙质沉着症临床特点与疾病风险因素  

Clinical characteristics and risk factors of tumor-like calcinosis

作　　者：刘南楠 曾艳梅[1] LIU Nannan;ZENG Yanmei(Department of Endocrinology and Metabolism,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院内分泌代谢科,广东广州510515

出　　处：《分子影像学杂志》2023年第6期1009-1014,共6页Journal of Molecular Imaging

基　　金：国家自然科学基金青年科学基金项目(81700771);广东省自然科学基金自由申请项目(2017A030313545)。

摘　　要：目的 探讨罕见病肿瘤样钙质沉着症(TC)的临床特点并分析疾病相关风险因素。方法 收集2001年1月~2021年8月就诊于南方医科大学南方医院并经手术病理确诊为TC的患者25例,分析统计临床特点、影像学表现及病理特征。将临床资料齐全的11例住院TC患者与11例年龄、性别匹配的健康对照者进行差异性分析,总结TC患者的生化特征,探讨可能导致该疾病的潜在风险因素。结果 X线多表现为软组织内的高密度钙化影。MRI表现为短T1长T2信号影,肿块内信号不均,边界清晰,局部可与滑膜囊相连。与健康人群相比,TC患者的血尿酸水平升高(P=0.038),血尿酸水平与TC患病率存在正相关关系,高尿酸导致TC的患病风险增加了3倍(RR=3,95%CI:1.041~8.646);高血磷TC患者的血磷和钙磷乘积较健康人群升高(P<0.05),高血磷导致TC的患病风险增加了3.2倍(RR=3.2,95%CI:1.547~6.619)。结论 高血磷和高尿酸增加TC的患病风险,在高尿酸血症和高磷血症患者中需注意鉴别TC,综合临床表现、生化结果、影像学表现、病理诊断使TC得到早期诊治。Objective To investigate the clinical characteristics of patients with tumor-like calcinosis(TC)in rare diseases and analyze the associated risk factors.Methods We collected clinical data and laboratory data on 25 patients with TC at Nanfang Hospital from January 2001 to August 2021.All the patients were diagnosed by surgical pathology.The clinical,imaging and pathological features were analyzed.Eleven hospitalized patients with complete clinical data and eleven age-and gender-matched healthy controls were enrolled into the study.The clinical and biochemical characteristics of TC patients were analyzed and summarized to explore the potential risk factors associated with the development of TC.Results X-ray of patients often showed high-density calcifications in soft tissues and MRI showed short T1 and long T2 signal shadows.The tumor exhibited uneven signal intensity,with clear boundary,and the local areas may be connected to the synovial capsule.Compared with healthy people,the serum uric acid levels were significantly increased in TC patients(P=0.038).The serum uric acid levels were positively correlated with the prevalence of TC,and the risk of TC increased by threefold(RR=3,95%CI:1.041-8.646).In addition,the product of serum phosphorus and calcium-phosphorus ratio in TC patients with hyperphosphatemia was increased significantly to the healthy population P<0.05.Hyperphosphatemia increased the risk of TC by 3.2-fold(RR=3.2,95%CI:1.547-6.619).Conclusion High serum phosphate and uric acid increased the risk of TC.Therefore,it was important to make a differential diagnosis between TC patients and patients with hyperuricemia or hyperphosphatemia.A comprehensive consideration,including age of disease onset,blood phosphorus concentration,past medical history,imaging,and pathological diagnosis could help to reduce the rate of misdiagnosis.

关 键 词：肿瘤样钙质沉着症 影像学 病理诊断 血磷 尿酸 

分 类 号：R68[医药卫生—骨科学] R816.8[医药卫生—外科学]