Serum bone turnover markers in patients with primary bone tumors.
OBJECTIVE
It was the aim of this study to investigate parameters of bone turnover such as serum bone-specific alkaline phosphatase (BALP) and N-terminal midfragment of osteocalcin (N-MID), as well as serum C-terminal telopeptide of type I collagen (CTX) in patients with primary bone tumors and to investigate their validity in differentiating malignant from benign bone tumors.


METHODS
A total of 219 patients with primary bone tumors entered the study. The patients were divided into 2 groups according to their age, including a teenage (10-19 years old) and an adult group (> or =20 years old). In each group, the patients were divided into several subgroups (osteosarcoma, benign bone tumors or tumor-like lesions, giant cell tumor, and other primary malignant bone tumors). An age- and gender-matched control population was also studied in each group. Blood samples were taken for measurement of serum BALP, N-MID and CTX.


RESULTS
The serum BALP levels in patients with osteosarcoma were significantly higher than those of patients in the other subgroups and the controls, both in the teenage (p = 0.01) and the adult group (p = 0.000). The serum N-MID and CTX levels did not significantly differ among patients of different subgroups and the controls, both in the teenage (p = 0.773 and p = 0.747, respectively) and the adult group (p = 0.163 and p = 0.074, respectively).


CONCLUSIONS
A high serum BALP level is valuable for the diagnosis of adult osteosarcoma, but its use in the development of a differential diagnosis in the teenage patients is not advised because serum BALP levels are also affected by age, pubertal stage and growth velocity. Both serum N-MID and serum CTX are hardly useful in the differential diagnosis of primary bone tumors.
Wang
Jingsheng
J
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China.
Pei
Fuxing
F
Tu
Chongqi
C
Zhang
Huaixian
H
Qiu
Xueyong
X
D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood* / Q000378:metabolism*; D002648:Child; D024042:Collagen Type I / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D015675:Osteocalcin / Q000097:blood
D015415:Biomarkers; D014408:Biomarkers, Tumor; D024042:Collagen Type I; D015675:Osteocalcin; D000469:Alkaline Phosphatase