title: Detection of Bone Metastases in Breast Cancer (BC) Patients by Serum Tartrate-Resistant Acid Phosphatase 5b (TRACP 5b), a Bone Resorption Marker and Serum Alkaline Phosphatase (ALP), a Bone Formation Marker, in Lieu of Whole Body Skeletal Scintigraphy with Technetium99m MDP.
abstract: Bone metastases are a serious problem in patients with advanced cancer disease and their presence usually signifies serious morbidity prior to the patient's death. In breast cancer patients the incidence of bone metastasis is observed to be very high at 70 %, as seen during post-mortem examination. Bone metastasis is difficult to diagnose, treat or follow clinically without radiological tools. This study was designed to evaluate the utility of a novel bone resorption marker-serum tartrate-resistant acid phosphatase 5b (TRACP5b) and the bone formation marker such as serum total alkaline phosphatase (ALP), in comparison with whole body skeletal scintigraphy with Technetium99m MDP for the diagnosis of bone metastases (BM) in breast cancer (BC) patients. This study is intended to help the clinician to diagnose bone metastasis without resorting to radiological tools, as they are not cost effective and carry the risk of radiation.
  
  
  METHODS
  Four groups of samples were analysed. 1st group consists 52 normal female (cancer free women), 2nd group consists 38 BC patients without bone metastasis, 3rd group consists 27 breast cancer patients with limited bone metastasis (3 or less than 3 skeletal lesions) and 4th group consists 35 breast cancer patients with extensive bone metastasis (4 or more than 4 skeletal lesions), conformed by whole body skeletal scintigraphy with Technetium99m MDP. One way ANOVA was used to compare serum TRACP5b and serum ALP among these groups. Both serum TRACP5b and serum ALP are not markedly elevated in limited bone metastasis but are strongly elevated in extensive bone metastasis (p < 0.0001). As seen in this study the biochemical bone resorption marker, serum TRACP5b, abnormally increased in extensive bone metastasis of breast cancer patients and can be used as a specific marker for bone metastasis in lieu of radiological tools.
authors: Department of Biotechnology, Nagarjuna University, Guntur, India.
authors: B K D
authors: BK
authors: Sarvari
authors: Department of Nuclear Medicine, MNJ Institute of Oncology and Regional Cancer Centre, Red Hills, Hyderabad, India.
authors: D
authors: D
authors: Sankara Mahadev
authors: Department of Biochemistry, Government General and Chest Hospital, Erragadda, Hyderabad, India.
authors: S
authors: S
authors: Rupa
authors: P. G. Dept. of Biotechnology & Microbiology, D. N. R. College, P. G. Courses and Research Centre, Bhimavaram, 534202 A. P. India.
authors: S A
authors: SA
authors: Mastan
keywords: 5b (TRACP5b); Bone metastasis (BM); Breast cancer (BC); Extensive bone metastasis (Ext.BM); Limited bone metastasis (Lim.BM); Scintigraphy; Tartrate-resistant acid phosphatase
references: Br J Surg. 1975 Sep;62(9):694-6
references: 1174812
references: J Nucl Med. 1988 Aug;29(8):1354-9
references: 3261330
references: J Cell Sci. 2000 Feb;113 ( Pt 3):377-81
references: 10639325
references: Clin Chem. 2001 Jan;47(1):74-80
references: 11148180
references: Cancer. 1997 Oct 15;80(8 Suppl):1538-45
references: 9362420
references: Calcif Tissue Int. 2002 Jul;71(1):20-5
references: 12073156
references: J Clin Oncol. 1994 Jul;12(7):1415-21
references: 8021732
references: Clin Chem. 2001 Mar;47(3):597-600
references: 11238321
references: Ann Surg Oncol. 1995 Jul;2(4):319-24
references: 7552621
references: Bone. 2004 Jan;34(1):187-94
references: 14751577
references: J Bone Miner Res. 2000 Jul;15(7):1337-45
references: 10893682
references: Cancer. 1997 Oct 15;80(8 Suppl):1546-56
references: 9362421
references: J Clin Oncol. 1995 May;13(5):1123-8
references: 7537797
references: Clin Chem Lab Med. 2002 Feb;40(2):143-51
references: 11939487
references: J Vet Med Sci. 2009 Dec;71(12 ):1637-42
references: 20046032