Value of C-telopeptide-cross-linked Type I collagen, osteocalcin, bone-specific alkaline phosphatase and procollagen Type I N-terminal propeptide in the diagnosis and prognosis of bone metastasis in patients with malignant tumors.
BACKGROUND
Studies show markers of bone turnover can help the clinician in the diagnosis and follow-up of bone metastases. The present study aimed to investigate the value of biochemical markers of bone turnover in the diagnosis and prognosis of bone metastases of malignant tumors.


METHODS
The serum levels of C-Telopeptide-Cross-Linked Type I Collagen (CTx), Procollagen Type I N-Terminal Propeptide (PINP), Bone-Specific Alkaline Phosphatase (B-ALP) and Osteocalcin (OST) in patients with bone metastases and control subjects were measured using radioimmunoassay and immunochemiluminescent assay.


RESULTS
The levels of CTx, PINP, B-ALP and OST in the metastasis group were significantly higher than those in both control groups and correlated with the number of bone metastatic sites. The levels of these markers were higher in prostate cancer patients with bone metastasis. The CTX of >426 ng/ml had the highest sensitivity and NPV, and PINP of >51.21 ng/ml had the highest specificity and PPV in healthy subjects. In addition, CTX of >547 ng/ml had the highest sensitivity and OST of >20.34 ng/ml the highest specificity in the non-metastasis group. Furthermore, both B-ALP of >15.55 ng/ml had relatively high negative predictive value and positive predictive value.


CONCLUSIONS
Biochemical markers of bone turnover, including CTx, PINP, B-ALP and OST, play important roles in the diagnosis and prognosis of metastatic bone cancer. CTX had a high sensitivity, and PINP had a high specificity in predicting bone metastasis. B-ALP is an ideal biochemical marker of bone turnover for metastatic bone cancer.
Department of Internal Oncology, Sixth People's Hospital, Shanghai JiaoTong University, Shanghai, China.
Hui
H
Zhao
Kui-Lu
KL
Han
Zhi-Yu
ZY
Wang
Yang
Y
Chen
Hong-Tao
HT
Li
Jun-Liu
JL
Zeng
Zan
Z
Shen
Yang
Y
Yao
D000469:Alkaline Phosphatase / Q000097:blood; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D002681:China; D024042:Collagen Type I / Q000097:blood; D005260:Female; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D009369:Neoplasms / Q000473:pathology*; D015675:Osteocalcin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood; D011379:Prognosis; D011863:Radioimmunoassay
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; D015675:Osteocalcin; D000469:Alkaline Phosphatase