Department of Medicine.
Department of Biostatistics and Epidemiology.
Ann Oncol. 2010 Sep;21(9):1864-1869. doi: 10.1093/annonc/mdq037. Epub 2010 Feb 24.
In patients with bone metastases from castration-resistant prostate cancer (CRPC) not pretreated with a bisphosphonate elevated N-telopeptide of type I collagen (uNTx), a marker of bone resorption, predicts skeletal-related events (SRE). The aim of this study was to assess the prognostic value of uNTx for overall survival (OS) and the incidence of SRE in patients with bone metastases from CRPC receiving zoledronic acid.
From 2004 to 2007, 94 patients with bone metastases from CRPC receiving zoledronic acid for at least 2 months were screened for uNTx.
Median age was 66 years (range 46-88). Median serum prostate-specific antigen (PSA) was 66 ng/ml (0-3984) and median uNTx was 19 nmol/mM creatinine (3-489). During follow-up, 38 patients (40%) experienced an SRE. Median OS was 20 months [95% (CI) confidence interval 15-24). In the multivariate analysis, elevated uNTx [hazard ratio (HR) 2.2 (95% CI 1.2-4.0)], serum PSA [HR 2.8 (95% CI 1.6-5.1)], and ECOG performance status were the only independent prognostic factors for OS. Median OS was 12 months (10-16) and 25 months (21-34) in patients with uNTx > or =20 nmol/mM creatinine and in those with uNTx <20 nmol/mM creatinine, respectively.
An elevated uNTx level is an independent prognostic factor for OS in patients with bone metastases from CRPC receiving a bisphosphonate.
在未经双膦酸盐预处理的去势抵抗性前列腺癌（CRPC）伴骨转移患者中，I 型胶原 N 末端肽（uNTx）升高，这是骨吸收的标志物，可预测骨骼相关事件（SRE）。本研究旨在评估 uNTx 对接受唑来膦酸治疗的 CRPC 伴骨转移患者总生存（OS）和 SRE 发生率的预后价值。
2004 年至 2007 年，对至少接受 2 个月唑来膦酸治疗的 94 例 CRPC 伴骨转移患者进行 uNTx 筛查。
中位年龄为 66 岁（范围 46-88 岁）。中位血清前列腺特异性抗原（PSA）为 66ng/ml（0-3984），中位 uNTx 为 19nmol/mM 肌酐（3-489）。在随访期间，38 例（40%）患者发生 SRE。中位 OS 为 20 个月[95%置信区间（CI）为 15-24]。在多变量分析中，升高的 uNTx[uNTx 越高，死亡风险越高，风险比（HR）为 2.2（95% CI 1.2-4.0）]、血清 PSA[HR 为 2.8（95% CI 1.6-5.1）]和 ECOG 表现状态是 OS 的唯一独立预后因素。uNTx >20nmol/mM 肌酐的患者中位 OS 为 12 个月（10-16），uNTx <20nmol/mM 肌酐的患者中位 OS 为 25 个月（21-34）。
在接受双膦酸盐治疗的 CRPC 伴骨转移患者中，升高的 uNTx 水平是 OS 的独立预后因素。
