骨转换代谢产物在肺癌患者骨转移诊断中的诊断价值。
Diagnostic value of bone-turnover metabolites in the diagnosis of bone metastases in patients with lung carcinoma.
作者信息
Izumi M, Nakanishi Y, Takayama K, Kimotsuki K, Inoue K, Wataya H, Minami T, Hara N
机构信息
Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
Cancer. 2001 Apr 15;91(8):1487-93. doi: 10.1002/1097-0142(20010415)91:8<1487::aid-cncr1156>3.0.co;2-2.
BACKGROUND
Several biochemical markers of bone formation and bone resorption have been developed recently. The authors evaluated the usefulness of new biomarkers, such as urinary deoxypyridinoline (D-PYD), serum pyridinoline cross-linked C-telopeptides of Type I collagen (1CTP), and urinary pyridinoline cross-linked N-telopeptides of Type I collagen (NTx), in the assessment of bone metastases in patients with lung carcinoma.
METHODS
The serum concentrations of 1CTP and the urinary concentrations of D-PYD and NTx were measured in 100 lung carcinoma patients, of whom 20 patients had bone metastases and 80 patients did not. Receiver operating characteristic (ROC) curves were drawn for these markers to compare their usefulness in detecting bone metastases originating in lung carcinoma.
RESULTS
Urinary concentrations of NTx in patients with bone metastases were significantly greater than in patients without bone metastases (147.1 +/- 129.3 pmol bone collagen equivalents [BCE]/micromol Cr vs. 47.2 +/- 29.9 pmol BCE/micromol Cr; P < 0.0001). Urinary concentrations of D-PYD in patients with bone metastases also were significantly greater than in patients without bone metastases (10.0 +/- 3.6 BCE/micromol Cr vs. 6.6 +/- 2.2 pmol BCE/micromol Cr; P = 0.0001). No significant difference was observed in serum concentrations of 1CTP between patients with and without bone metastases. A moderate but significant correlation was seen between NTx and D-PYD (correlation coefficient [R] = 0.435; P < 0.0001) and between D-PYD and 1CTP (R = 0.525; P < 0.0001). NTx had a better ROC curve than D-PYD and 1CTP (the areas under the ROC curve were 0.84, 0.79, and 0.62, respectively). Using the threshold of 62.5 pmol BCE/micromol Cr for NTx, sensitivity, specificity, and accuracy were 0.800, 0.737, and 0.750, respectively.
CONCLUSIONS
In the current study, the measurement of NTx appeared to be most useful as a marker of bone metastases in patients with lung carcinoma.
背景
最近已开发出几种骨形成和骨吸收的生化标志物。作者评估了新的生物标志物，如尿脱氧吡啶啉（D-PYD）、血清I型胶原吡啶啉交联C末端肽（1CTP）和尿I型胶原吡啶啉交联N末端肽（NTx），在评估肺癌患者骨转移中的作用。
方法
对100例肺癌患者测定血清1CTP浓度、尿D-PYD和NTx浓度，其中20例有骨转移，80例无骨转移。绘制这些标志物的受试者操作特征（ROC）曲线，以比较它们在检测源自肺癌的骨转移中的作用。
结果
有骨转移患者的尿NTx浓度显著高于无骨转移患者（147.1±129.3皮摩尔骨胶原当量[BCE]/微摩尔肌酐vs.47.2±29.9皮摩尔BCE/微摩尔肌酐；P<0.0001）。有骨转移患者的尿D-PYD浓度也显著高于无骨转移患者（10.0±3.6BCE/微摩尔肌酐vs.6.6±2.2皮摩尔BCE/微摩尔肌酐；P = 0.0001）。有骨转移和无骨转移患者的血清1CTP浓度无显著差异。NTx与D-PYD之间存在中度但显著的相关性（相关系数[R]=0.435；P<0.0001），D-PYD与1CTP之间也存在相关性（R = 0.525；P<0.0001）。NTx的ROC曲线比D-PYD和1CTP更好（ROC曲线下面积分别为0.84、0.79和0.62）。以NTx的阈值62.5皮摩尔BCE/微摩尔肌酐计算，敏感性、特异性和准确性分别为0.800、0.737和0.750。
结论
在本研究中，测定NTx似乎是评估肺癌患者骨转移最有用的标志物。
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