Endokrine paraneoplastische Syndrome

  • R. Arnold
Conference paper

Zusammenfassung

Es ist seit langem bekannt, daß maligne Tumoren neben ihrer Eigenschaft, invasiv, expansiv und metastatisch zu wachsen, humorale und hormonale Faktoren produzieren können. Ursprünglich sah man die Eigenschaft maligner, nicht endokriner Tumoren zur Hormonproduktion als ungewöhnliche Rarität an und führte sie auf die Derepression der genetischen Information zurück [19]. Odell postulierte demgegenüber, daß alle Malignome im Prinzip die Fähigkeit zur Protein- und ektopen Hormonproduktion besitzen [26]. Das Auftreten charakteristischer Syndrome ist jedoch an die Sekretion biologisch aktiver Substanzen gebunden. Der Begriff „Paraneoplastisches Syndrom“ wird somit definiert als das Auftreten von Symptomen oder Symptom-Komplexen, die nicht durch das Tumorwachstum selbst oder durch tumorbedingte Obstruktion verursacht werden, sondern die sich vom Tumor oder dessen Metastasen entfernt manifestieren [12, 26]. Die am besten charakterisierten paraneoplastischen Syndrome sind auf nichtendokrine Tumoren zurückzuführen, die eine ektope endokrine Potenz besitzen und Polypeptid-Hormone synthetisieren und sezernieren (Tabelle 1). Eine paraneoplastische Endokrinopathie ist so ein Beispiel für die Multipotenz von Tumorzellen. Die Beobachtung, daß primär nichtendokrine Tumoren vorzugsweise zur Expression von Proteinen und Proteohormonen, nicht aber zur Steroidhormonsynthese befähigt sind, könnte in der Komplexität des für die Steroidbiosynthese erforderlichen enzymatischen Apparates einer Zelle begründet sein.

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© Springer-Verlag Berlin Heidelberg 1987

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  • R. Arnold

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