Kobayashi Y, Ochi M, Tokue A
Department of Urology, Shimotsuga General Hospital.
Hinyokika Kiyo. 2000 Dec;46(12):869-72.
Type I collagen cross-linked N-telopeptide (NTx) in urine, the degraded form of type I collagen cross-linked in bone, has been evaluated as a marker of bone resorption. In this study, the clinical usefulness of NTx as a marker of bone metastasis of prostate cancer was compared with that the carboxyterminal propeptide of type I procollagen (PICP), the aminoterminal propeptide of type I procollagen (PINP), and the pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP) in serum. We assessed 37 cases of prostatic cancer in which the diagnosis had been confirmed pathologically. The patients were 15 patients with prostatic cancer with bone metastasis (before treatment or during a relapse) (Group 1); 11 patients, with bone metastasis, but for whom treatment was effective and condition had stabilized (Group 2); and 11 patients, with localized prostatic cancer and no evidence of bone metastasis (Group 3). The serum PICP, PINP, and ICTP levels and concentration of NTx in urine were compared among the three groups with the Mann-Whitney U test, with p values less than 0.05 considered significant. Urine NTx concentrations in Groups 1, 2 and 3 were 539.3 +/- 202.9, 160.6 +/- 97.6 and 48.6 +/- 7.6 nMBCE/mMCr, respectively. The differences between the Group 1 and Group 2 and between Group 1 and Group 3 were significant (p < 0.01 and p < 0.001). The differences between Group 1 and Group 3 and between Group 2 and Group 3 were significant for serum PICP, PINP and ICTP concentrations (p < 0.05). The correlation coefficient between urine NTx and each serum bone metabolic marker was 0.8 for PICP, 0.4 for PINP and 0.5 for ICTP. These bone metabolic markers are promising clinical markers of bone metastatic and may be useful for prediction of therapeutic efficacy and recurrence in bone and quantification of the extent of bone metastates.
尿中I型胶原交联N-端肽（NTx）是骨中交联I型胶原的降解形式，已被评估为骨吸收的标志物。在本研究中，将NTx作为前列腺癌骨转移标志物的临床实用性与血清中I型前胶原羧基端前肽（PICP）、I型前胶原氨基端前肽（PINP）和I型胶原吡啶啉交联羧基端肽（ICTP）的临床实用性进行了比较。我们评估了37例经病理确诊的前列腺癌病例。患者分为三组：15例前列腺癌骨转移患者（治疗前或复发期间）（第1组）；11例有骨转移但治疗有效且病情稳定的患者（第2组）；11例局限性前列腺癌且无骨转移证据的患者（第3组）。采用Mann-Whitney U检验比较三组患者的血清PICP、PINP和ICTP水平以及尿中NTx浓度，p值小于0.05被认为具有统计学意义。第1组、第2组和第3组的尿NTx浓度分别为539.3±202.9、160.6±97.6和48.6±7.6 nMBCE/mMCr。第1组与第2组以及第1组与第3组之间的差异具有统计学意义（p<0.01和p<0.001）。第1组与第3组以及第2组与第3组之间血清PICP、PINP和ICTP浓度的差异具有统计学意义（p<0.05）。尿NTx与各血清骨代谢标志物的相关系数分别为：与PICP为0.8，与PINP为0.4，与ICTP为0.5。这些骨代谢标志物有望成为骨转移的临床标志物，可能有助于预测骨转移的治疗效果和复发情况以及量化骨转移的范围。
