title: Lectin affinity electrophoresis of serum alkaline phosphatase in metastasized breast cancer.
abstract: The use of serum alkaline phosphatase (ALP) isoenzymes as markers of breast cancer metastases and treatment efficacy has received little attention. Twenty-six breast cancer women (56+/-13 years, all post-menopausal) were prospectively evaluated during their first and third course of chemotherapy (4-week interval). Serum samples were analyzed for ALP isoenzymes (bone, liver, and intestine) using a lectin affinity electrophoresis kit (Hydragel 15 ISO-PAL, Sebia) adapted on a semi-automated Hydrasys system (Sebia). Results were compared with imaging techniques for the presence of metastases; bone ALP isoenzyme (B-ALP) results were compared with C-Terminal degradation products of type I collagen (S-CTX) (CrossLaps, IDS Nordic). Serum B-ALP, but not S-CTX, confirmed the presence of bone metastases (BM) (n=15) with 67/100% sensitivity/specificity (using a 69 UI/L ROC cut-off); ROC AUC was 0.806 (P=0.0004) (NS for S-CTX). Chemotherapy reduced serum B-ALP by 24% over 4 weeks (P=0.0012); there was no change for S-CTX. There was no specific clinical pattern for other ALP isoenzymes (liver and intestine). In conclusion, serum B-ALP, but not S-CTX, could help confirm the presence of BM in breast cancer patients.
authors.affiliation: Laboratoire de Biochimie, Hôpital St Louis, Claude Vellefaux, Paris, France. thierry.le-bricon@sls.ap-hop-paris.fr
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Bricon
authors.forename: Cécile
authors.initials: C
authors.lastname: Gay-Bellile
authors.forename: Paul
authors.initials: P
authors.lastname: Cottu
authors.forename: Mourad
authors.initials: M
authors.lastname: Benlakehal
authors.forename: Hélène
authors.initials: H
authors.lastname: Guillon
authors.forename: Pascal
authors.initials: P
authors.lastname: Houzé
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000201:enzymology / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy / Q000201:enzymology* / Q000473:pathology; D024042:Collagen Type I / Q000097:blood; D004586:Electrophoresis; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008875:Middle Aged; D009362:Neoplasm Metastasis; D014909:Wheat Germ Agglutinins / Q000737:chemistry*
chemical_list: D014408:Biomarkers, Tumor; D024042:Collagen Type I; D007527:Isoenzymes; D014909:Wheat Germ Agglutinins; D000469:Alkaline Phosphatase