Implications of Serum Bone Turnover Markers in Prostate Cancer Patients With Bone Metastasis
Implications of Serum Bone Turnover Markers in Prostate Cancer Patients With Bone Metastasis
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DOI：
10.1016/j.urology.2009.11.049
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发表时间：
2010-06-01
期刊：
影响因子：
2.1
通讯作者：
Ichikawa, Tomohiko
中科院分区：
文献类型：
--
作者：
Kamiya, Naoto;Suzuki, Hiroyoshi;Ichikawa, Tomohiko
目的 评估血清骨转换标记物检测前列腺癌 (PCa) 患者骨转移的诊断准确性，并评估这些标记物作为 PCa 死亡率预测因子的有用性。 方法 血清总碱性磷酸酶、骨特异性碱性磷酸酶、I 型胶原羧基末端吡啶啉交联端肽部分 (1CTP)、5b 型酒石酸酸性磷酸酶和前列腺特异性抗原对 222 名患者（58 名骨转移患者、57 名 T2M0 PCa 患者、55 名 T3M0 PCa 患者和 52 名无 PCa 患者）测量了 (PSA) 水平。使用多变量逐步逻辑回归分析来确定骨转移的独立预测因素。使用受试者操作特征分析评估血清标志物水平与骨转移的相关性。采用多变量Cox比例风险分析预测PCa骨转移患者的病因特异性生存率。结果骨转移患者血清总碱性磷酸酶、骨特异性碱性磷酸酶、1CTP、抗酒石酸酸性磷酸酶5b型和PSA水平显着升高，且与骨显像病变程度显着相关。多变量逐步逻辑回归分析表明，血清PSA和1CTP是骨转移的显着预测因子。受试者操作特征分析表明，血清 1CTP 水平是骨转移最可靠的预测因子（曲线下面积 = 0.85）。多变量Cox比例风险分析显示，只有血清1CTP是PCa相关死亡的独立预后因素。 结论 血清1CTP水平是检测骨转移扩散和预测PCa骨转移患者生存概率的更可靠的标志物。泌尿学 75: 1446-1451, 2010。(c) 2010 Elsevier Inc.
OBJECTIVES To assess the diagnostic accuracy of serum bone turnover markers for detection of bone metastasis in patients with prostate cancer (PCa) and to assess the usefulness of these markers as predictors of mortality from PCa.METHODS Serum total alkaline phosphatase, bone-specific alkaline phosphatase, carboxy-terminal pyridinoline cross-linked telopeptide parts of type-I collagen (1CTP), tartrate-resistant acid phosphatase type 5 b, and prostate-specific antigen (PSA) levels were measured in 222 patients (58 with bone metastasis, 57 with T2M0 PCa, 55 with T3M0 PCa, and 52 without PCa). Multivariate stepwise logistic regression analysis was used to identify independent predictors of bone metastasis. Correlation of serum marker levels with bone metastasis was assessed using receiver operating characteristics analysis. Multivariate Cox proportional hazards analysis was used to predict cause-specific survival in PCa patients with bone metastasis.RESULTS Serum total alkaline phosphatase, bone-specific alkaline phosphatase, 1CTP, tartrate-resistant acid phosphatase type 5 b, and PSA levels were significantly elevated in patients with bone metastasis, and correlated significantly with the extent of disease on bone scintigraphy. Multivariate stepwise logistic regression analysis demonstrated that serum PSA and 1CTP were significant predictors of bone metastasis. Receiver operating characteristics analyses showed that serum 1CTP level was the most reliable predictor of bone metastasis (area under the curve = 0.85). Multivariate Cox proportional hazards analysis revealed that only serum 1CTP was an independent prognostic factor for PCa-related death.CONCLUSIONS Serum 1CTP level was a more reliable marker than the others to detect bone metastatic spread and to predict survival probability in PCa patients with bone metastasis. UROLOGY 75: 1446-1451, 2010. (c) 2010 Elsevier Inc.