title: [Clinical significance of combined detection of urine NTX and serum ICTP for breast cancer patients with bone metastases].
abstract: OBJECTIVE
  To study the clinical significance and prognostic value of combined detection of urinary N-terminal telopeptide of type Ⅰ collagen (NTx) and serum C-terminal telopeptide of type Ⅰ collagen (ICTP) in breast cancer patients with bone metastases.
  
  
  METHODS
  Serum and urine samples from 68 women with advanced breast cancer who received the treatment in Jilin Cancer Hospital between October 2012 and October 2008 were collected before and 2 months after treatment. Among them, 35 patients had bone metastases (group A), including 12 cases with single bone metastasis and 23 cases with multiple bone metastases. 33 out of the 68 patients had other organ metastases (group B). 30 healthy females were included as the control group (group C). The levels of urine NTX and serum ICTP were measured by ELISA.
  
  
  RESULTS
  The levels of NTx and ICTP of group A were significantly higher than those of groups B and C [NTx: (7.17±1.11) nmol/L vs. (2.08±0.22) nmol/L and (2.09±0.24) nmol/L, respectively, (P<0.05); ICTP: (7.75±1.14) ng/ml vs. (2.15±0.34) ng/ml and (2.22±0.31) ng/ml, respectively, (P<0.05)], while no significant difference was found between the groups B and C. Compared with the patients with single bone metastasis, the patients with ≥2 bone metastases had significantly higher NTx and ICTP levels [NTx: (7.69±0.93) nmol/L vs. (6.16±0.62) nmol/L, P<0.05; ICTP: (8.21±1.00) ng/ml) vs. (6.88±0.81) ng/ml (P<0.05)]. At two months after treatment, 40.0%(14/35) of patients with bone metastasis had partial remission (PR), 42.9%(15/35) of patients had stable disease (SD), and 6 patients with progressive disease (PD). Both urinary NTx and serum ICTP of the patients with PR and SD were significantly decreased compared with those before treatment (P<0.05). 10 cases of patients (28.6%) with bone metastases had skeletal-related events (SREs) during the treatment, including one PR patient (1/14, 7.1%), 5 SD patients (5/15, 33.3%) and 4 PD patients (4/6, 66.7%).
  
  
  CONCLUSIONS
  The combined detection of urinary NTx and serum ICTP is of important significance for early diagnosis and efficacy evaluation and to control skeletal-related adverse events in breast cancer patients with bone metastases.
authors.affiliation: Department of Internal Medicine, Jilin Cancer Hospital, Changchun 130012, China.
authors.forename: C J
authors.initials: CJ
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine, Jilin Cancer Hospital, Changchun 130012, China.
authors.forename: L X
authors.initials: LX
authors.lastname: Ma
authors.affiliation: Department of Internal Medicine, Jilin Cancer Hospital, Changchun 130012, China.
authors.forename: J
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Internal Medicine, Jilin Cancer Hospital, Changchun 130012, China.
authors.forename: J J
authors.initials: JJ
authors.lastname: Liu
authors.affiliation: Department of Internal Medicine, Jilin Cancer Hospital, Changchun 130012, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Cheng
mesh_terms: D014408:Biomarkers, Tumor; D001859:Bone Neoplasms; D001943:Breast Neoplasms; D024042:Collagen Type I; D005260:Female; D006801:Humans; D010455:Peptides
chemical_list: D014408:Biomarkers, Tumor; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide