Jung Klaus, Stephan Carsten, Semjonow Axel, Lein Michael, Schnorr Dietmar, Loening Stefan A
Department of Urology, University Hospital Charité, Humboldt University, Berlin, Germany.
J Urol. 2003 Dec;170(6 Pt 1):2302-5. doi: 10.1097/01.ju.0000094191.39574.cb.
We evaluated the behavior and diagnostic usefulness of the osteoclastogenesis proteins osteoprotegerin and receptor activator of nuclear factor-kappaB ligand (RANKL) in the serum of patients with prostate cancer (PCa).
Serum osteoprotegerin and RANKL were retrospectively measured in 117 patients with prostate cancer, including 39 with stage pN0M0, 34 with stage pN1M0 and 44 with bone metastases, in 35 presumably healthy men and in 35 patients with benign prostatic hyperplasia (BPH). The association of these components with clinical data (tumor stage and grade) and receiver operating characteristics curves compared with the bone formation marker alkaline phosphatase and bone resorption marker crosslaps (cross-linked C-terminal telopeptides of type I collagen) were calculated.
Osteoprotegerin was increased in patients with bone metastases, while those with localized cancer or lymph node metastases had values similar to those in presumably healthy controls and patients with BPH. RANKL did not differ among the control, BPH and PCa subgroups. Thus, the ratio of osteoprotegerin-to-RANKL showed behavior similar to that of osteoprotegerin. Osteoprotegerin and RANKL did not show any significant correlation with tumor stage, histological tumor grade, total prostate specific antigen, alkaline phosphatase activity or crosslaps. ROC analysis data proved that osteoprotegerin had a better diagnostic accuracy than alkaline phosphatase or crosslaps for detecting bone metastases in PCa cases.
Serum osteoprotegerin but not RANKL indicates disturbed osteoclastogenesis in patients with PCa and bone metastatic spread. It could be used as a marker for bone metastases.
我们评估了破骨细胞生成蛋白骨保护素和核因子κB受体活化因子配体（RANKL）在前列腺癌（PCa）患者血清中的表现及诊断价值。
回顾性检测了117例前列腺癌患者的血清骨保护素和RANKL，其中包括39例pN0M0期患者、34例pN1M0期患者和44例有骨转移的患者，同时检测了35例健康男性和35例良性前列腺增生（BPH）患者的上述指标。计算这些指标与临床数据（肿瘤分期和分级）的相关性，并绘制受试者工作特征曲线，与骨形成标志物碱性磷酸酶和骨吸收标志物交联C末端肽（I型胶原交联C末端肽）进行比较。
骨转移患者的骨保护素水平升高，而局限性癌或淋巴结转移患者的骨保护素水平与健康对照组和BPH患者相似。RANKL在对照组、BPH组和PCa亚组之间无差异。因此，骨保护素与RANKL的比值表现与骨保护素相似。骨保护素和RANKL与肿瘤分期、组织学肿瘤分级、总前列腺特异性抗原、碱性磷酸酶活性或交联C末端肽均无显著相关性。ROC分析数据证明，在检测PCa患者的骨转移方面，骨保护素比碱性磷酸酶或交联C末端肽具有更好的诊断准确性。
血清骨保护素而非RANKL表明PCa伴骨转移扩散患者存在破骨细胞生成紊乱。它可作为骨转移的标志物。
