Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
Curr Opin Support Palliat Care. 2010 Sep;4(3):127-34. doi: 10.1097/SPC.0b013e32833ac6d6.
The skeleton is typically the first site of metastasis in patients with prostate cancer, and bone metastases can result in severe bone pain and potentially debilitating fractures. Although bone scans are a reliable means of assessing osteoblastic lesions, tools for monitoring early changes in bone health are lacking. Biochemical markers of bone turnover might fulfill this unmet need.
Correlative studies have suggested that bone-marker levels may have utility in assessing disease progression and response to bone-directed therapy. Elevated levels of the markers, N-telopeptide of type I collagen and bone-specific alkaline phosphatase, are associated with higher rates of death and skeletal-related events in the bone metastasis setting. Marker levels also correlate with response to zoledronic acid treatment, and similar data with the investigational agent, denosumab, are emerging.
Changes in bone-marker levels reflect alterations in skeletal homeostasis and can provide important insights into bone disease progression and response to bone-directed therapy in patients with prostate cancer. More mature data from currently ongoing clinical trials will provide further insight on the utility of marker assessments as an adjunct to established monitoring methods in prostate cancer.
骨骼通常是前列腺癌患者转移的第一部位，骨转移可导致严重骨痛和潜在的致残性骨折。虽然骨扫描是评估成骨病变的可靠方法，但缺乏监测骨骼健康早期变化的工具。骨转换的生化标志物可能满足这一未满足的需求。
相关研究表明，骨标志物水平可能有助于评估疾病进展和对骨靶向治疗的反应。在骨转移情况下，I 型胶原 N-末端肽和骨碱性磷酸酶等标志物水平升高与较高的死亡率和骨骼相关事件发生率相关。标志物水平也与唑来膦酸治疗的反应相关，正在出现与研究药物地舒单抗类似的数据。
骨标志物水平的变化反映了骨骼内稳态的改变，可以为了解前列腺癌患者的骨骼疾病进展和对骨靶向治疗的反应提供重要信息。目前正在进行的临床试验的更成熟数据将进一步深入了解标志物评估作为前列腺癌既定监测方法的辅助手段的效用。
