title: Type I collagen degradation product (ICTP) gives information about the nature of bone metastases and has prognostic value in prostate cancer.
abstract: Although osteosclerotic bone metastases are characteristic of prostate cancer, mixed metastases with a lytic component are not uncommon. Type I collagen is synthesised by osteoblasts and accounts for about 90% of the organic matrix of bone. We have used new specific immunoassays for PICP (carboxy-terminal propeptide of type I procollagen) and ICTP (cross-linked carboxy-terminal telopeptide of type I collagen) which allow simultaneous assessment of the synthesis and degradation of type I collagen respectively. Forty patients with bone metastases due to prostate cancer at the time of diagnosis were investigated with these methods. Twenty-three of them had sclerotic (S) and 17 had mixed metastases with sclerotic and lytic components (S + L) as assessed by radiographs. The concentrations of PICP and ICTP in serum as well as the activity of alkaline phosphatase (AP) were increased in all patients of the S + L group, who had more aggressive bone disease and a shorter survival than the S group (P < 0.017). The ICTP level was above the reference range in half of the patients in the S group, whereas the PICP and AP levels were elevated in 35%. Of the bone markers, only ICTP was of prognostic significance (P < .05). We conclude that ICTP and PICP give information about the type and activity of the skeletal metastases. In addition, ICTP predicts prognosis.
authors.affiliation: Division of Urology, University of Tampere, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Kylmälä
authors.forename: T L
authors.initials: TL
authors.lastname: Tammela
authors.forename: L
authors.initials: L
authors.lastname: Risteli
authors.forename: J
authors.initials: J
authors.lastname: Risteli
authors.forename: M
authors.initials: M
authors.lastname: Kontturi
authors.forename: I
authors.initials: I
authors.lastname: Elomaa
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood / Q000378:metabolism* / Q000556:secondary*; D001862:Bone Resorption / Q000097:blood / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism; D003094:Collagen / Q000097:blood* / Q000378:metabolism*; D024042:Collagen Type I; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood*; D010865:Pilot Projects; D011347:Procollagen / Q000097:blood; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000097:blood / Q000378:metabolism* / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C042813:procollagen type I carboxy terminal peptide; D003094:Collagen; D000469:Alkaline Phosphatase