Zissimopoulos Athanassios, Petrakis Georgios, Stellos Kappaonstantinos, Baziotis Nikolaos
Medical School of Democritus University of Thrace, Alexandroupolis, Greece.
Hell J Nucl Med. 2006 Jan-Apr;9(1):60-4.
The most common metastases of breast cancer (BC) are bone metastases. Serum pro-Iota collagen peptide (PICP) and I collagen telopeptide (ICTP) levels indicate the rate of bone collagen synthesis and bone resorption respectively and therefore indicate metastatic activity in the bone. We have studied the clinical importance of serum PICP and ICTP as well as CA 15-3 and CEA and compared them to bone scintigraphy findings indicating metastases from BC. Ninety seven women of mean age 58+/-8 years with BC were examined. The diagnosis of BC was histologically confirmed. Bone metastases were diagnosed in 68 of them by bone scans performed after the intravenous injection of 925 MBq of technetium-99m methylendiphosphonate, while 29 patients were free from bone metastases. We also examined 52 women of similar age, as controls. Serum PICP, ICTP, CA 15-3 and CEA were measured in both patients and controls. Serum levels of ICTP and CA 15-3 were significantly higher in patients with BC and bone metastases compared to patients without metastases (P<0.05), while PICP and CEA were only marginally higher. A statistically significant correlation was observed between the existence of bone metastases and ICTP serum levels (P<0.05). The sensitivity of PICP, ICTP, CEA and CA 15-3 was 28.1%, 48.6%, 78%, 42% respectively and their specificity was 83.9%, 94%, 65% and 86% respectively.
ICTP and CA 15-3 are the most reliable markers of those studied for the diagnosis of bone metastases in BC. PICP alone or combined with ICTP were not sensitive enough. CA 15-3 showed sensitivity 78% and specificity 86%. When combining CA 15-3, ICTP and CEA the sensitivity and specificity increased to 82% and 96% accordingly.
乳腺癌（BC）最常见的转移部位是骨转移。血清前I型胶原肽（PICP）和I型胶原末端肽（ICTP）水平分别指示骨胶原合成速率和骨吸收情况，因此可反映骨转移活性。我们研究了血清PICP、ICTP以及CA 15 - 3和癌胚抗原（CEA）的临床重要性，并将它们与提示BC骨转移的骨闪烁显像结果进行比较。对97名平均年龄为58±8岁的BC女性进行了检查。BC诊断经组织学确认。其中68人通过静脉注射925 MBq的锝 - 99m亚甲基二膦酸盐后进行骨扫描诊断为骨转移，而29名患者无骨转移。我们还检查了52名年龄相仿的女性作为对照。对患者和对照者均检测了血清PICP、ICTP、CA 15 - 3和CEA。与无转移的患者相比，有骨转移的BC患者血清ICTP和CA 15 - 3水平显著更高（P<0.05），而PICP和CEA仅略高。骨转移的存在与ICTP血清水平之间存在统计学显著相关性（P<0.05）。PICP、ICTP、CEA和CA 15 - 3的敏感性分别为28.1%、48.6%、78%、42%，特异性分别为83.9%、94%、65%和86%。
在研究的指标中，ICTP和CA 15 - 3是诊断BC骨转移最可靠的标志物。单独的PICP或与ICTP联合使用敏感性均不足。CA 15 - 3的敏感性为78%，特异性为86%。当联合使用CA 15 - 3、ICTP和CEA时，敏感性和特异性相应提高到82%和96%。
