Biochemical markers for the detection of bone metastasis in patients with prostate cancer: diagnostic efficacy and the effect of hormonal therapy
Biochemical markers for the detection of bone metastasis in patients with prostate cancer: diagnostic efficacy and the effect of hormonal therapy
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DOI：
10.1007/s007740170059
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发表时间：
2001-01-01
影响因子：
3.3
通讯作者：
Fukunaga, M
中科院分区：
文献类型：
--
作者：
Tamada, T;Sone, T;Fukunaga, M
在本研究中，我们研究了骨转换生化标记物对检测前列腺癌骨转移的诊断有效性以及激素治疗引起的这些标记物水平的变化。 95 名前列腺癌患者被分为三组之一：26 名骨转移患者 (BM(+))、35 名非激素治疗无骨转移患者 (BM(-)HT(-)) 和 34 名激素治疗无骨转移患者 (BM(-)HT(+))。 BM(+)组的所有患者均接受了激素治疗。检查以下骨转换生化标志物的血清或尿液水平：骨特异性碱性磷酸酶（B-ALP）、骨钙素（OC）、I型前胶原C-前肽（PICP）、I型胶原交联C-端肽（ICTP）、C-端肽片段（CTx）、N-端肽片段（NTx）、总吡啶啉（T-Pyr）、总脱氧吡啶啉(T-D-Pyr) 和游离脱氧吡啶啉 (F-D-Pyr)。 BM(+)组的B-ALP、PICP、NTx、CTx、T-Pyr、T-D-Pyr和F-D-Pyr的值显着高于BM(-)HT(-)组。与BM(-)HT(+)组相比，BM(+)组的B-ALP、ICTP、NTx、T-Pyr和T-D-Pyr的值显着升高。 BM(-)HT(-)组和BM(-)HT(+)组的B-ALP、NTx、CTx、T-D-Pyr和F-D-Pyr水平存在显着差异。除 OC 和 CTx 外，所有标志物均与骨闪烁扫描的骨转移程度显着相关。在所有标记物中，接受者操作特征 (ROC) 分析显示，B-ALP 和 F-D-Pyr 分别对于区分 BM(+) 和 BM(-)HT(-) 组之间的骨形成和骨吸收最为敏感和特异。相比之下，B-ALP 和 ICTP 对于 BM(+) 和 BM(-)HT(+) 组之间的分化最为敏感和特异。结果提示，激素治疗对PICP、CTx和F-D-Pyr诊断骨转移的疗效影响较大，而对ICTP影响较小。尽管骨代谢标志物可用于诊断前列腺癌骨转移，但在评估时应牢记激素治疗对骨代谢的影响。
In the present study, we investigated the diagnostic effectiveness of biochemical markers of bone turnover for the detection of bone metastasis from prostate cancer and changes in the levels of these markers caused by hormonal therapy. Ninety-five patients with prostate cancer were divided into one of three groups: 26 patients with bone metastasis (BM(+)), 35 patients without bone metastasis on nonhormonal therapy (BM(-)HT(-)) and 34 patients without bone metastasis on hormonal therapy (BM(-)HT(+)). All patients in the BM(+) group had received hormonal therapy. Serum or urinary levels of the following biochemical markers of bone turnover were examined: bone-specific alkaline phosphatase (B-ALP), osteocalcin (OC), type I procollagen C-propeptide (PICP), type I collagen cross-linked C-telopeptide (ICTP), C-telopeptide fragment (CTx), N-telopeptide fragment (NTx), total pyridinoline (T-Pyr), total deoxypyridinoline (T-D-Pyr) and free deoxypyridinoline (F-D-Pyr). The BM(+) group showed significantly higher values than the BM(-)HT(-) group for B-ALP, PICP, NTx, CTx, T-Pyr, T-D-Pyr, and F-D-Pyr. Compared with the BM(-)HT(+) group, the BM(+) group showed significantly higher values for B-ALP, ICTP, NTx, T-Pyr and T-D-Pyr. The levels of B-ALP, NTx, CTx, T-D-Pyr and F-D-Pyr were significantly different between the BM(-)HT(-) and BM(-)HT(+) groups. All markers, except OC and CTx, significantly were correlated with the extent of bone metastasis on bone scintigraphy. Of all markers, receiver operating characteristic (ROC) analyses revealed B-ALP and F-D-Pyr to be the most sensitive and specific for differentiation between the BM(+) and BM(-)HT(-) groups with regard to bone formation and resorption, respectively. In contrast, B-ALP and ICTP were most sensitive and specific for differentiation between the BM(+) and BM(-)HT(+) groups. The results suggest that hormonal therapy greatly affects the efficacy of PICP, CTx and F-D-Pyr in the diagnosis of bone metastasis, whereas its effects on ICTP are small. Although bone metabolic markers would be useful in the diagnosis of bone metastasis from prostate cancer, the effects of hormonal therapy on bone metabolism should be kept in mind in their evaluation.