title: Clinical significance of the serum crosslinked N-telopeptide of type I collagen as a prognostic marker for non-small-cell lung cancer.
abstract: BACKGROUND
  Lung cancer is the leading cause of cancer-related death. Many patients with lung cancer are in its advanced stages at the time of diagnosis. The 5-year survival rate for lung cancer is 10% to 20%, and the prognosis for patients with lung cancer is still poor. The crosslinked N-terminal telopeptide of type I collagen (NTx) is a metabolite of type I collagen, the main constituent of bone matrix.
  
  
  METHODS
  We measured serum NTx levels in patients who underwent staging during hospitalization for the initial treatment of lung cancer in our department. We examined whether serum NTx levels would be relevant to the prognosis of non-small-cell lung cancer (NSCLC).
  
  
  RESULTS
  This study included 176 patients with lung cancer (125 men and 51 women), including 109 with adenocarcinoma, 53 with squamous cell carcinoma, 6 with large-cell carcinoma, and 8 with other cancer types. Univariate and multivariate analysis using the Cox proportional hazards model revealed a particularly close association between sex, performance status, disease stage, and serum NTx levels and overall survival (OS). A median OS of 368 days was observed for patients with a serum NTx level < 22 nmol BCE/L, which was significantly longer than the 197 days for patients with a serum NTx level ≥ 22 nmol BCE/L (hazard ratio [HR], 2.02; 95% confidence interval [CI], 1.36-2.99; log-rank P = .00037).
  
  
  CONCLUSIONS
  We have revealed that a high serum NTx level (> 22 nmol BCE/L) appears to be a risk factor for a reduction in OS in patients with NSCLC.
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization Osaka, Prefectural Medical Center for Respiratory and Allergic Diseases, Osaka, Japan. moto19781205@yahoo.co.jp
authors.forename: Motohiro
authors.initials: M
authors.lastname: Tamiya
authors.forename: Masashi
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Morimura
authors.forename: Tomomi
authors.initials: T
authors.lastname: Yasue
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakasuji
authors.forename: Morita
authors.initials: M
authors.lastname: Satomu
authors.forename: Okafuji
authors.initials: O
authors.lastname: Kohei
authors.forename: Shiroyama
authors.initials: S
authors.lastname: Takayuki
authors.forename: Naoko
authors.initials: N
authors.lastname: Morishita
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Shinji
authors.initials: S
authors.lastname: Sasada
authors.forename: Norio
authors.initials: N
authors.lastname: Okamoto
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hirashima
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000556:secondary; D024042:Collagen Type I / Q000097:blood*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010455:Peptides / Q000097:blood*; D016016:Proportional Hazards Models; D012737:Sex Factors; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase