转移性乳腺癌患者尿中DPD交联物分泌情况——一种疗效评估的可能性

The course of the urinary DPD-crosslink secretion in metastatic breast cancer--a possibility for response assessment.

作者信息

Lüftner D, Günther S, Flath B, Müller C, Echteroff K, Mergenthaler H G, Wernecke K D, Possinger K

机构信息

Medizinische Klinik und Poliklinik II, Humboldt-Universität Berlin, Germany.

出版信息

Anticancer Res. 1999 Jul-Aug;19(4A):2537-44.

PMID:10470191

Abstract

BACKGROUND

Urinary deoxypyridinoline (DPD)-crosslinks have been shown to be a highly specific parameter for type I collagen metabolism.

MATERIALS AND METHODS

In a prospective breast cancer study, urine samples were collected in after-care patients and in patients with bone metastases. DPD-crosslinks were measured every three weeks using a fully automated chemiluminescence immunoassay. Bone metastases were confirmed by bone scan and/or x-ray, and were followed-up over six months. To validate the test, a receiver operating characteristics (ROC)-curve was set up to find the DPD cut-off concentration which separates patients with no evidence of disease (NED) from patients with bone metastases.

RESULTS

73 breast cancer patients (41 with NED, 32 with bone metastases) were included into the ROC analysis. At a DPD cut-off value of 8 nmol/mmol creatinine, we found the best sensitivity (84.4%) for the detection of bone metastases with a specificity of 70.7%. Patients with stable bone disease under intravenous pamidronate treatment (90 mg q3w) and specific therapy had a significant (p = 0.007) fall of the DPD-crosslinks in comparison to the progressive subset with 72.7% falling below 8 nmol/mmol.

CONCLUSIONS

We conclude that the net bone turnover is not increased at a DPD-crosslinks elimination < 8 nmol/mmol.

摘要

背景

尿脱氧吡啶啉（DPD）交联物已被证明是I型胶原代谢的一个高度特异性参数。

材料与方法

在一项前瞻性乳腺癌研究中，收集了随访期患者和骨转移患者的尿液样本。每三周使用全自动化学发光免疫分析法测量DPD交联物。通过骨扫描和/或X线确认骨转移，并随访六个月。为验证该检测方法，绘制了受试者工作特征（ROC）曲线以确定区分无疾病证据（NED）患者和骨转移患者的DPD临界浓度。

结果

73例乳腺癌患者（41例NED，32例骨转移）纳入ROC分析。当DPD临界值为8 nmol/mmol肌酐时，我们发现检测骨转移的最佳灵敏度为84.4%，特异性为70.7%。接受静脉注射帕米膦酸二钠治疗（90 mg，每三周一次）和特异性治疗的骨病稳定患者，与病情进展亚组相比，DPD交联物显著下降（p = 0.007），72.7%的患者下降至8 nmol/mmol以下。