Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy.
Biomarkers. 2013 Mar;18(2):121-5. doi: 10.3109/1354750X.2012.745166. Epub 2013 Jan 22.
The impact on the survival of bone metastases (BM) in patients with neuroendocrine tumor (NET) is a matter of debate. BM have a key role in causing symptoms and in decreasing patients' quality of life. Although the mechanisms of the development of BM are not completely clear, it is now well understood that the Receptor Activator of Nuclear factor Kappa-B-/Ligand (RANK/RANKL)/osteoprotegerin (OPG) pathway plays a relevant role.
To characterize the RANK/RANKL/OPG pathway in patients affected with NET.
Two cohorts of 15 patients each were enrolled in the study; one cohort was affected with NET without BM and the second cohort was affected with NET with BM. The serum RANK/RANKL/OPG pathway was assessed in both the groups.
Serum OPG levels and RANKL/OPG ratio were lower and higher, respectively, in NET patients harboring BM than in those without BM. During the ROC analysis, a cut-off value of 1071 pg/ml for OPG and 0.62 for RANKL/OPG ratio were able to significantly distinguish between the two groups.
This study indicates that RANK/RANKL/OPG pathway is imbalanced in patients with NET harboring BM. Specific alterations of this pathway could predict an early development of BM.
骨转移（BM）对神经内分泌肿瘤（NET）患者生存的影响是一个有争议的问题。BM 是导致症状和降低患者生活质量的关键因素。虽然 BM 发展的机制尚不完全清楚，但现在已经清楚地了解到核因子κB 受体激活剂/配体（RANK/RANKL）/骨保护素（OPG）途径起着相关的作用。
描述影响 NET 患者的 RANK/RANKL/OPG 途径。
本研究纳入了两组各 15 名患者；一组患有无 BM 的 NET，另一组患有 BM 的 NET。在两组患者中均评估了血清 RANK/RANKL/OPG 途径。
与无 BM 的 NET 患者相比，患有 BM 的 NET 患者的血清 OPG 水平和 RANKL/OPG 比值分别更低和更高。在 ROC 分析中，OPG 的截断值为 1071 pg/ml，RANKL/OPG 比值的截断值为 0.62，这两个值能够显著区分两组患者。
本研究表明，患有 BM 的 NET 患者的 RANK/RANKL/OPG 途径失衡。该途径的特定改变可能预测 BM 的早期发展。
