Zissimopoulos A, Stellos K, Matthaios D, Petrakis G, Parmenopoulou V, Babatsikou F, Matthaiou E, Theodosiadou E, Hountis P, Koutis C
Department of Nuclear Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
J BUON. 2009 Jul-Sep;14(3):463-72.
In this study we evaluated the clinical usefulness of serum pro-I collagen peptide (PICP) and I collagen telopeptide (ICTP) as indicators of early bone metastases in patients with breast (BC), lung (LC), urinary bladder (UBC) and prostate cancer (PC).
305 patients were examined. 145 had histologically confirmed BC (92 with bone metastases), 20 UBC (6 with bone metastases), 11 LC (3 with bone metastases) and 129 PC (68 with bone metastases). In BC patients we compared the PICP and ICTP levels with those of CA 15-3, CEA and bone scintigraphy. Patients with LC and UBC had PICP and ICTP measurements, PC patients had serum PICP, prostate specific antigen (PSA) measurements and bone scans. 104 healthy individuals served as controls.
ICTP and CA 15-3 levels were significantly higher in patients with BC and bone metastases in comparison to patients without metastases (p <0.05), while PICP and CEA were only marginally higher. Significant correlation was observed between existence of bone metastases and ICTP levels (p <0.05). The sensitivity of PICP, ICTP, CEA and CA 15-3 was 28.1, 48.6, 42, and 78%, respectively and specificity was 83.9, 94, 65 and 86%, respectively. ICTP and CA 15-3 were the most reliable markers for early diagnosis of bone metastases in BC. PICP alone or with ICTP were not sensitive enough. Only CA 15-3 showed sensitivity 78% and specificity 86%. When combined CA 15-3, ICTP and CEA the sensitivity and specificity increased to 82% and 96%, respectively. Furthermore, PICP and PSA levels were significantly higher in patients with PC and bone metastases in comparison to patients with benign prostate hyperplasia (BPH) (p <0.0001) or in patients with PC without bone metastases (p <0.0005 for PICP and p <0.0001 for PSA). The co-evaluation of PICP and PSA improved the sensitivity (78%), specificity (96%), accuracy (97%) and positive predictive value (97%). In LC patients, ICTP levels differed significantly between patients with and without bone metastases (p=0.025). In UBC patients, PICP levels differed significantly between patients with and without bone metastases (p=0.017).
ICTP and CA 15-3 are the most reliable markers for early diagnosis of bone metastases in BC patients. PICP could be useful for diagnosing early bone metastases of PC and combined with PSA and bone scan can be an additional tool in the follow-up of PC patients. For LC patients, ICTP showed a significant difference in the discrimination of patients with and without bone metastases. In UBC patients, PICP showed a significant difference in the discrimination of patients with and without bone metastases.
在本研究中，我们评估了血清前I型胶原蛋白肽（PICP）和I型胶原蛋白端肽（ICTP）作为乳腺癌（BC）、肺癌（LC）、膀胱癌（UBC）和前列腺癌（PC）患者早期骨转移指标的临床实用性。
对305例患者进行了检查。145例经组织学确诊为BC（92例有骨转移），20例UBC（6例有骨转移），11例LC（3例有骨转移）和129例PC（68例有骨转移）。在BC患者中，我们将PICP和ICTP水平与CA 15 - 3、CEA水平以及骨闪烁显像结果进行了比较。LC和UBC患者进行了PICP和ICTP检测，PC患者进行了血清PICP、前列腺特异性抗原（PSA）检测以及骨扫描。104名健康个体作为对照。
与无转移的患者相比，BC伴骨转移患者的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水平之间存在显著相关性（p <0.05）。PICP、ICTP、CEA和CA 15 - 3的敏感性分别为28.1%、48.6%、42%和78%，特异性分别为83.9%、94%、65%和86%。ICTP和CA 15 - 3是BC患者早期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。仅CA 15 - 3的敏感性为78%，特异性为86%。当CA 15 - 3、ICTP和CEA联合使用时，敏感性和特异性分别提高到82%和96%。此外，与良性前列腺增生（BPH）患者相比，PC伴骨转移患者的PICP和PSA水平显著更高（p <0.0001），与无骨转移的PC患者相比也显著更高（PICP为p <0.0005，PSA为p <0.0001）。PICP和PSA的联合评估提高了敏感性（78%）、特异性（96%）、准确性（97%）和阳性预测值（97%）。在LC患者中，有骨转移和无骨转移患者的ICTP水平差异显著（p = 0.025）。在UBC患者中，有骨转移和无骨转移患者的PICP水平差异显著（p = 0.017）。
ICTP和CA 15 - 3是BC患者早期骨转移最可靠的标志物。PICP可用于诊断PC的早期骨转移，与PSA和骨扫描联合可作为PC患者随访的额外工具。对于LC患者，ICTP在区分有骨转移和无骨转移患者方面显示出显著差异。对于UBC患者，PICP在区分有骨转移和无骨转移患者方面显示出显著差异。
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