title: Serum bone-specific alkaline phosphatase as a biomarker for osseous metastases in patients with malignant carcinomas: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Bone metastasis was common in patients with malignant tumors. The purpose of this study was to investigate the serum bone-specific alkaline phosphatase (B-ALP) as a biomarker in the diagnosis of osseous metastases in patients with cancers.
  
  
  METHODS
  We searched the databases of Pubmed, Cochrane Library, Medline, CNKI and Wanfang to screen the relevant articles about the serum B-ALP detection in the diagnosis of osseous metastases in patients with malignant carcinomas. The pooled sensitivity, specificity, summary receiver operating characteristic (SROC) curve were calculated by STATA12.0 software.
  
  
  RESULTS
  Nineteen trials with 3 268 subjects were finally included in this study. The mean level of serum B-ALP was 41.50 ± 26.61 μg/L (216.90 ± 139.00U/L) in patients with osseous metastases and 14.49 ± 5.52 μg/L (103.30 ± 39.44 U/L) in patients without osseous metastases. The serum level of B-ALP was significant higher in the osseous metastases group than that in the control group (P < 0.05); The pooled sensitivity and specificity for diagnosis of osseous metastases were 0.74 with its 95% confidence interval (95% CI) of 0.62-0.83 and 0.80 (95% CI: 0.67-0.89), respectively. The area under the SRCO was 0.86 (95% CI: 0.83-0.89).
  
  
  CONCLUSIONS
  Serum B-ALP can be a promising biomarker for detection of osseous metastases in patients with cancers.
authors.forename: Wen-Xi
authors.initials: WX
authors.lastname: Du
authors.forename: Shu-Fang
authors.initials: SF
authors.lastname: Duan
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Chen
authors.forename: Jie-Feng
authors.initials: JF
authors.lastname: Huang
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Yin
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.
authors.forename: Pei-Jian
authors.initials: PJ
authors.lastname: Tong
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D001842:Bone and Bones / Q000473:pathology; D002277:Carcinoma / Q000097:blood* / Q000473:pathology*; D016022:Case-Control Studies; D006801:Humans; D009362:Neoplasm Metastasis / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D000469:Alkaline Phosphatase