[骨代谢溶骨性生化指标与乳腺癌骨转移患者治疗效果的关系]

[Relationship of osteolytic biochemical indicators of bone metabolism with the therapeutic effect in breast cancer patients with bone metastases].

作者信息

Li Shu-fen, Wang Xiao-rui, Wang Chen, Chen Ying, Ren Li, Cui Lin, Tong Zhong-sheng

机构信息

Department of Medical Oncology, Cancer Hospital of Tianjin Medical University, Tianjin 300060, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2009 Dec;31(12):911-5.

PMID:20193330

Abstract

OBJECTIVE

The aim of this study was to access the relationship of osteolytic bone metabolic markers such as serum type I collagen carboxy-terminal telopeptide (sICTP), N-terminal cross-linked telopeptides of type I collagen (uNTx), urinary pyridinoline (uPyd) with the therapeutic effect in breast cancer patients with bone metastases.

METHODS

120 patients with breast cancer were included in this study. The levels of sICTP, uNTx and uPYD were measured by ELISA assay. The differences were compared between patients with and without bone metastasis. The patients with bone metastasis were treated and followed up as clinically indicated.

RESULTS

The levels of all above mentioned biomarkers in patients with bone metastasis were significantly higher than that in patients without bone metastasis (P < 0.01). A significant correlation was found between each two markers (r > 0.5, P < 0.01). The biomarkers were examined again in 45 patients with bone metastasis after treatment to evaluate the treatment response. The median follow-up was 10 months. Based on clinical evaluation criteria, 25 patients were responders and 20 were non-responders. For responders, after 3 months treatment, the levels of the three bone markers were significantly reduced (P = 0.025, P < 0.001, P < 0.001). But for non-responders, with progression of bone lesions, the levels of the three markers were significantly raised (P = 0.011, P = 0.002, P = 0.002). By means of multiple logistic regression with stepwise selection, the uPyd and uNTx activities were closely correlated with treatment response (OR = 17.0, P = 0.019; OR = 16.7, P = 0.015), however, the sICTP did not show any correlation with treatment response P = 0.841).

CONCLUSION

The levels of sICTP, uNTx and uPyd may be used as indicators in assessment of the effect of antiresorptive treatment and evaluation of prognosis in breast cancer patient with bone metastases.

摘要

目的

本研究旨在探讨血清Ⅰ型胶原羧基末端肽（sICTP）、Ⅰ型胶原N端交联肽（uNTx）、尿吡啶啉（uPyd）等溶骨性骨代谢标志物与乳腺癌骨转移患者治疗效果之间的关系。

方法

本研究纳入120例乳腺癌患者。采用酶联免疫吸附测定法检测sICTP、uNTx和uPYD水平。比较有骨转移和无骨转移患者之间的差异。对有骨转移的患者进行临床指征性治疗及随访。

结果

骨转移患者上述所有生物标志物水平均显著高于无骨转移患者（P<0.01）。两两标志物之间均存在显著相关性（r>0.5，P<0.01）。对45例骨转移患者治疗后再次检测生物标志物以评估治疗反应。中位随访时间为10个月。根据临床评估标准，25例患者为反应者，20例为无反应者。对于反应者，治疗3个月后，三种骨标志物水平显著降低（P=0.025，P<0.001，P<0.001）。但对于无反应者，随着骨病变进展，三种标志物水平显著升高（P=0.011，P=0.002，P=0.002）。通过逐步选择的多因素逻辑回归分析，uPyd和uNTx活性与治疗反应密切相关（OR=17.0，P=0.019；OR=16.7，P=0.015），然而，sICTP与治疗反应无相关性（P=0.841）。