Plasma osteopontin in comparison with bone markers as indicator of bone metastasis and survival outcome in patients with prostate cancer.
BACKGROUND
The study was undertaken to evaluate the diagnostic and prognostic value of plasma osteopontin (OPN) in comparison to bone markers as well as the relationships between the markers and clinico-pathological factors in prostate cancer (PCa) patients.


METHODS
OPN and the bone markers carboxyterminal-telopeptide of type I collagen, bone-specific alkaline phosphatase (bALP), and aminoterminal-propeptide of type I procollagen (PINP) were measured in 90 PCa patients with and without bone metastases, 35 patients with benign prostatic hyperplasia, and 29 healthy men.


RESULTS
OPN and bone markers were significantly elevated in patients with bone metastases compared to the other groups. Significant correlations were found between all four-bone markers (r(s) = 0.43-0.79, all P < 0.01). OPN correlated with tumor grade (r(s) = 0.23, P < 0.05). In receiver-operating characteristics (ROC) analyses, OPN and bone markers were effective in distinguishing PCa patients with and without bone metastases showing areas under the curve (AUC) between 0.80 and 0.88 (all P < 0.001). OPN had an AUC of 0.85 that increased in combination with bALP up to 0.93 providing at the point with the highest diagnostic accuracy both a sensitivity and specificity of about 90%. Kaplan-Meier analyses and Cox proportional hazards regression models showed decreased survival of patients with high OPN and bone marker levels, while only high OPN and PINP were independent negative prognostic factors for PCa-related death.


CONCLUSIONS
OPN alone or in combination with bone markers is useful as diagnostic marker in the detection of bone metastases and as prognosticator in the survival prediction in PCa patients.
Ramankulov
Azizbek
A
Department of Urology, Charité--University Medicine Berlin, Campus Charité Mitte, Berlin, Germany.
Lein
Michael
M
Kristiansen
Glen
G
Loening
Stefan A
SA
Jung
Klaus
K
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood* / Q000556:secondary*; D024042:Collagen Type I; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D053495:Osteopontin / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides; D011237:Predictive Value of Tests; D011347:Procollagen / Q000097:blood; D016016:Proportional Hazards Models; D011470:Prostatic Hyperplasia / Q000097:blood / Q000473:pathology; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology*; D012372:ROC Curve
D014408:Biomarkers, Tumor; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide; D053495:Osteopontin; D000469:Alkaline Phosphatase