Díaz-Martín M A, Traba M L, De La Piedra C, Guerrero R, Méndez-Dávila C, De La Peña E G
Department of Biochemistry, Fundación Jiménez Díaz, Madrid, Spain.
Scand J Clin Lab Invest. 1999 Apr;59(2):125-32. doi: 10.1080/00365519950185850.
The aim of this work was to evaluate the usefulness of serum aminoterminal propeptide of type I collagen (PINP) in the early detection of bone metastases associated with prostatic carcinoma. The results were compared with those of bone isoenzyme of alkaline phosphatase (bAP). Levels of total alkaline phosphatase (TAP) and prostatic specific antigen (PSA), related to the existence of bone metastases, are also evaluated. Fifty-five male patients aged 70-80 years were studied. Nine presented a benign prostatic hyperplasia (BPH) and the rest clinically confirmed prostatic cancer. Cancer patients were classified in accordance with the staging grouping of the International Union Against Cancer/American Joint Committee on Cancer TNM 1992 Revision: stage 0 or BPH (n=9), I (n=6), II (n=12), III (n=18) and IV (n=10). According to this classification, patients of groups BPH, I, II and III have no evidence of metastases. Those of stage IV present any type of metastases. In the case of this work, all patients of group IV presented bone metastases. Some patients of group BPH, I and II were untreated. The rest of the patients were under treatment (radical prostatectomy, telecobaltotherapy or hormonal therapy) for a period of between 6 months and 15 years. Serum PSA (Quimioluminiscence, IMMULITE), PINP (RIA, Orion Diagnostica), bAP (IRMA, Tamdem R-Ostase, Hybritech), and TAP (autoanalyzer) were determined. We found the following sensitivities and specificities (relating the presence of bone metastases to values higher than the upper limit of normality and, in the case of PSA, to values higher than 100 microg/L): (1) PINP: 100% (10/10) and 87% (39/45), (2) bAP: 90% (9/10) and 82% (37/45), (3) TAP: 60% (6/10) and 93% (42/45), (4) PSA: 40% (4/10) and 100% (45/45). These results suggest that PINP and bAP are adequate biochemical markers of bone formation to be used in the detection of bone metastases in prostatic carcinoma, improving the sensitivity and specificity of TAP and PSA. With respect to PINP, bAP presents the disadvantage of its cross-reactivity with liver isoenzyme.
本研究旨在评估血清I型胶原氨基端前肽（PINP）在早期检测前列腺癌相关骨转移中的作用。将结果与碱性磷酸酶骨同工酶（bAP）的结果进行比较。还评估了与骨转移存在相关的总碱性磷酸酶（TAP）和前列腺特异性抗原（PSA）水平。研究了55名年龄在70 - 80岁的男性患者。9例患有良性前列腺增生（BPH），其余为临床确诊的前列腺癌。癌症患者根据国际抗癌联盟/美国癌症联合委员会1992年修订版的TNM分期分组进行分类：0期或BPH组（n = 9）、I期（n = 6）、II期（n = 12）、III期（n = 18）和IV期（n = 10）。根据该分类，BPH、I、II和III组患者无转移证据。IV期患者存在任何类型的转移。在本研究中，IV组所有患者均有骨转移。BPH、I和II组的一些患者未接受治疗。其余患者接受了6个月至15年的治疗（根治性前列腺切除术、远距离钴疗法或激素疗法）。测定了血清PSA（化学发光法，IMMULITE）、PINP（放射免疫分析法，Orion Diagnostica）、bAP（免疫放射分析法，Tamdem R - Ostase，Hybritech）和TAP（自动分析仪）。我们发现了以下敏感性和特异性（将骨转移的存在与高于正常上限的值相关联，对于PSA，与高于100μg/L的值相关联）：（1）PINP：100%（10/10）和87%（39/45），（2）bAP：90%（9/10）和82%（37/45），（3）TAP：60%（6/10）和93%（42/45），（4）PSA：40%（4/10）和100%（45/45）。这些结果表明，PINP和bAP是用于检测前列腺癌骨转移的合适的骨形成生化标志物，提高了TAP和PSA的敏感性和特异性。关于PINP，bAP存在与肝脏同工酶交叉反应的缺点。
