在癌症环境中使用尿液标志物：文献综述。
Use of urinary markers in cancer setting: A literature review.
机构信息
Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Department of Pharmacy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Bone Oncol. 2015 Feb 27;4(1):18-23. doi: 10.1016/j.jbo.2015.01.002. eCollection 2015 Mar.
INTRODUCTION
In bone metastases, the disruption of normal bone processes results in increased resorption and formation rates, which can often be quantitatively measured by biomarkers in the urine and blood. The purpose of this review is to summarize relevant studies of urinary markers used as a diagnostic and/or prognostic tool, as well as its potential and advances in directing therapy.
METHODS
A literature search was conducted using Ovid MEDLINE (1950 to July 2014), EMBASE (1950 to 2014 week 30) and Cochrane Central Register of Controlled Trials (3rd Quarter 2014) to identify studies that detailed the use of urinary markers in the cancer setting, specifically involving markers for bone metastases. Search terms included "urinary markers", "cancer", and "bone metastases".
RESULTS
A total of 35 articles, with 24 original studies, were identified. In general, urinary markers can be used to detect early signs of bone metastases prior to skeletal imaging, but still must be used in conjunction with imaging to avoid false positive results. The use of urinary markers, such as N-telopeptide, as a prognostic tool remains controversial, but can provide information on the relative risk of skeletal related events (SREs), disease progression, as well as death. Finally, while urinary markers have shown to be potentially useful in confirming the efficacy of bone metastases treatments, exploring the appropriate dosages for treatment, and directing therapy, it is still unclear to what extent urinary markers should be reduced by.
CONCLUSION
The potential use of urinary markers in the management of bone metastases is promising as it can allow for earlier and more convenient detection of bone metastases in comparison to other techniques. However, additional studies involving prospective clinical trials are suggested to further examine the potential of urinary markers in developing appropriate treatment strategies and endpoints, especially in developing a clearer protocol on the extent urinary markers should be reduced by to correlate with achievement of clinical benefit.
简介
在骨转移中，正常骨过程的破坏导致吸收和形成速率增加，这些速率通常可以通过尿液和血液中的生物标志物进行定量测量。本综述的目的是总结用于诊断和/或预后的尿液标志物的相关研究，以及其在指导治疗方面的潜力和进展。
方法
通过 Ovid MEDLINE（1950 年至 2014 年 7 月）、EMBASE（1950 年至 2014 年第 30 周）和 Cochrane 对照试验中心注册库（2014 年第 3 季度）进行文献检索，以确定详细描述尿液标志物在癌症背景下应用的研究，特别是涉及骨转移标志物的研究。检索词包括“urinary markers”、“cancer”和“bone metastases”。
结果
共确定了 35 篇文章，其中包括 24 项原始研究。总的来说，尿液标志物可用于在骨骼成像之前检测骨转移的早期迹象，但仍必须与影像学检查结合使用，以避免假阳性结果。尿标志物（如 N-端肽）作为预后工具的使用仍存在争议，但可以提供关于骨骼相关事件（SREs）、疾病进展和死亡的相对风险的信息。最后，虽然尿标志物在确认骨转移治疗的疗效方面显示出潜在的有用性，但在探索治疗的适当剂量和指导治疗方面仍存在疑问，尚不清楚应减少多少尿标志物。
结论
尿液标志物在骨转移管理中的潜在应用很有前景，因为与其他技术相比，它可以更早、更方便地检测骨转移。然而，建议进行更多涉及前瞻性临床试验的研究，以进一步研究尿液标志物在制定适当的治疗策略和终点方面的潜力，特别是在制定更明确的方案以确定尿标志物减少的程度与临床获益的相关性方面。
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