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Biochemical markers and skeletal metastases

作者:Laurence M. Demers, Luís Costa, Allan Lipton · 发表于:Cancer · 年份:2000 · DOI:10.1002/1097-0142(20000615)88:12+<2919::aid-cncr7>3.0.co;2-z · 被引用次数:167 · 研究领域:Bone health and treatments、Alkaline Phosphatase Research Studies、Bone health and osteoporosis research

BACKGROUND: Skeletal metastases are common occurrences in patients with malignancies such as breast and prostate carcinoma, but they are difficult to diagnose nonradiologically, and treatment is difficult to follow clinically. Recent developments suggest that biochemical markers of bone remodeling, such as the bone collagen breakdown product N-telopeptide and the bone formation marker known as bone specific alkaline phosphatase, hold great promise as clinical tools for the management of patients with metastatic bone disease. METHODS: Serum levels of the bone formation marker known as bone specific alkaline phosphatase (BAP), along with serum levels of the bone collagen breakdown product carboxyterminal telopeptide of Type I collagen (ICTP) and urine levels of pyridinoline (PYD), deoxypridinoline (DPD), and N-telopeptide (NTx), were measured in a large cohort of patients with newly diagnosed or progressive cancer of the breast, prostate, lung, and other sites. Bone marker levels were correlated with the presence or absence of bone scan-documented metastases; metastatic disease extension in terms of the number of skeletal sites involved; and the type of lesion, whether blastic or lytic. Sites examined included the pelvis, spine, skull, ribs, and long bones. RESULTS: All of the bone markers examined, including BAP and NTx, were abnormally elevated in a high proportion of patients with confirmed metastases to bone. Urine NTx levels and bone specific alkaline phosphatase were sign...