title: Elevated serum P1NP predicts development of bone metastasis and survival in early-stage breast cancer.
abstract: Bone is the most common site of metastasis of breast cancer, affecting most women with advanced disease. Procollagen type I N-terminal propeptide (P1NP), osteocalcin, CTX, and IL-6 are markers of bone turnover. Our objective was to determine whether serum levels of these proteins have clinical utility as predictors of breast cancer metastasis to bone. Blood was collected before treatment from 164 patients with stage I-III breast cancer from September 2001 to December 2008. Serum levels of P1NP, CTX, IL-6, and OC were measured using an automated immunoassay system. Correlations of the levels of these markers with time to bone metastasis development and with overall survival (OS) rate were assessed using Cox proportional hazards regression analysis and the Kaplan-Meier method. Fifty-five patients with stage I-III disease at the time of blood sample collection subsequently experienced metastasis to bone. A baseline P1NP level of at least 75 ng/mL predicted increased risk of bone metastasis (hazard ratio, 2.7 [95 % confidence interval, 1.2-6.0]; P = 0.031) and a poor OS rate (P = 0.031). Serum P1NP levels at or above 75 ng/mL correlate with a short time to development of bone metastasis and low overall survival in patients with stage I-III breast cancer.
authors.affiliation: Department of Breast Medical Oncology, Unit 1354, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
authors.forename: Windy
authors.initials: W
authors.lastname: Dean-Colomb
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Hess
authors.forename: Elliana
authors.initials: E
authors.lastname: Young
authors.forename: Terrie G
authors.initials: TG
authors.lastname: Gornet
authors.forename: Beverly C
authors.initials: BC
authors.lastname: Handy
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Moulder
authors.forename: Nuhad
authors.initials: N
authors.lastname: Ibrahim
authors.forename: Lajos
authors.initials: L
authors.lastname: Pusztai
authors.forename: Daniel
authors.initials: D
authors.lastname: Booser
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Esteva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood* / Q000401:mortality / Q000556:secondary*; D001943:Breast Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology*; D024042:Collagen Type I / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000097:blood; D011237:Predictive Value of Tests; D011347:Procollagen / Q000097:blood*; D012044:Regression Analysis
chemical_list: 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