Detection of Bone Metastases in Breast Cancer (BC) Patients by Serum Tartrate-Resistant Acid Phosphatase 5b (TRACP 5b), a Bone Resorption Marker and Serum Alkaline Phosphatase (ALP), a Bone Formation Marker, in Lieu of Whole Body Skeletal Scintigraphy with Technetium99m MDP
Detection of Bone Metastases in Breast Cancer (BC) Patients by Serum Tartrate-Resistant Acid Phosphatase 5b (TRACP 5b), a Bone Resorption Marker and Serum Alkaline Phosphatase (ALP), a Bone Formation Marker, in Lieu of Whole Body Skeletal Scintigraphy with Technetium99m MDP
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DOI：
10.1007/s12291-013-0399-8
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发表时间：
2015-01-01
影响因子：
2.1
通讯作者：
Mastan, S. A.
中科院分区：
文献类型：
--
作者：
Sarvari, B. K. D.;Mahadev, D. Sankara;Mastan, S. A.
骨转移是晚期癌症患者的严重问题，其存在通常意味着患者死亡前的严重发病率。在乳腺癌患者中，观察到骨转移的发生率非常高，为70%，如在尸检期间所见。骨转移瘤在临床上没有放射学工具很难诊断、治疗或随访。本研究旨在评价一种新的骨吸收标志物-血清抗酒石酸酸性磷酸酶5 b（TRACP 5 b）和骨形成标志物如血清总碱性磷酸酶（ALP）在诊断乳腺癌（BC）患者骨转移（BM）中的应用，并与锝99 mMDP全身骨显像进行比较。这项研究旨在帮助临床医生诊断骨转移，而不诉诸放射学工具，因为它们不符合成本效益，并进行辐射的风险。实验设计：分析了四组样品。第1组为正常女性52例第二组包括38名无骨转移的BC患者，第三组包括27名有局限性骨转移的乳腺癌患者第四组包括35例乳腺癌伴广泛骨转移患者（4处或4处以上骨骼病变），经锝99 m MDP全身骨骼X线摄影证实。采用单因素方差分析比较各组间血清TRACP 5 b和血清ALP。局限性骨转移患者血清TRACP 5 b和ALP均无明显升高，而广泛性骨转移患者血清TRACP 5 b和ALP均显著升高（p < 0.0001）。如本研究中所见，生化骨吸收标志物血清TRACP 5 b在乳腺癌患者的广泛骨转移中异常增加，并且可以代替放射学工具用作骨转移的特异性标志物。
Bone metastases are a serious problem in patients with advanced cancer disease and their presence usually signifies serious morbidity prior to the patient's death. In breast cancer patients the incidence of bone metastasis is observed to be very high at 70 %, as seen during post-mortem examination. Bone metastasis is difficult to diagnose, treat or follow clinically without radiological tools. This study was designed to evaluate the utility of a novel bone resorption marker-serum tartrate-resistant acid phosphatase 5b (TRACP5b) and the bone formation marker such as serum total alkaline phosphatase (ALP), in comparison with whole body skeletal scintigraphy with Technetium99m MDP for the diagnosis of bone metastases (BM) in breast cancer (BC) patients. This study is intended to help the clinician to diagnose bone metastasis without resorting to radiological tools, as they are not cost effective and carry the risk of radiation. Experimental design: Four groups of samples were analysed. 1st group consists 52 normal female (cancer free women), 2nd group consists 38 BC patients without bone metastasis, 3rd group consists 27 breast cancer patients with limited bone metastasis (3 or less than 3 skeletal lesions) and 4th group consists 35 breast cancer patients with extensive bone metastasis (4 or more than 4 skeletal lesions), conformed by whole body skeletal scintigraphy with Technetium99m MDP. One way ANOVA was used to compare serum TRACP5b and serum ALP among these groups. Both serum TRACP5b and serum ALP are not markedly elevated in limited bone metastasis but are strongly elevated in extensive bone metastasis (p < 0.0001). As seen in this study the biochemical bone resorption marker, serum TRACP5b, abnormally increased in extensive bone metastasis of breast cancer patients and can be used as a specific marker for bone metastasis in lieu of radiological tools.