Department of Respiratory, Ningbo No. 2 Hospital, Ningbo, No. 41 Northwest Street, Haishu District, Ningbo, 315010, Zhejiang, China.
Int J Clin Oncol. 2017 Dec;22(6):1015-1025. doi: 10.1007/s10147-017-1159-1. Epub 2017 Jul 4.
A number of studies have investigated the clinical significance of bone turnover markers (BTMs) for the diagnosis of bone metastasis (BM) in lung cancer; however, they led to contradictory results. The aim of this meta-analysis was to investigate whether BTMs differ between lung cancer patients with and without BM.
Articles were identified by searching Medline, Embase, Web of Science and Scopus. The studies that were identified were pooled and the weighted mean difference (WMD) and its corresponding 95% confidence interval (CI) were calculated. Subgroup analyses and publication bias detection were also conducted.
A final analysis of 1720 subjects (707 patients with BM and 1013 patients without BM) was performed from 16 cohort studies. From the pooled data in the meta-analysis, the total alkaline phosphatase (TALP) (104.35 U/l [95% CI 33.36-175.34]), bone-specific ALP (BALP) (13.24 μg/l [95% CI 8.50-17.98] or 6.84 U/l [95% CI 2.98-10.70]), C-terminal cross-linked telopeptide of type I collagen (ICTP) (5.07 μg/l [95% CI 3.58-6.56]) and N-terminal cross-linked telopeptide of type I collagen (NTX) (5.08 nM bone collagen equivalent/l [95% CI 2.82-7.33]) were significantly lower among BM patients than non-BM patients. Subgroup analyses detected that the serum level of tartrate-resistant acid phosphatase isoform 5b was significantly reduced in Caucasian patients with BM (-0.64 U/l [95% CI -1.02 to -0.25]), while increased in Asian patients with BM (2.69 U/l [95% CI 0.08-5.31]), compared to patients without BM.
The present meta-analysis suggested that serum measurement of TALP, BALP, ICTP and NTX might be helpful in detecting BM in lung cancer.
多项研究调查了骨转换标志物（BTM）在肺癌骨转移（BM）诊断中的临床意义；然而，它们得出了相互矛盾的结果。本荟萃分析的目的是探讨肺癌患者中 BM 患者和非 BM 患者的 BTM 是否存在差异。
通过检索 Medline、Embase、Web of Science 和 Scopus 来确定文章。对确定的研究进行汇总，并计算加权均数差（WMD）及其相应的 95%置信区间（CI）。还进行了亚组分析和发表偏倚检测。
对 16 项队列研究的 1720 名受试者（707 名 BM 患者和 1013 名非 BM 患者）进行了最终分析。荟萃分析中的汇总数据显示，总碱性磷酸酶（TALP）（104.35 U/L [95%CI 33.36-175.34]）、骨特异性碱性磷酸酶（BALP）（13.24 μg/L [95%CI 8.50-17.98]或 6.84 U/L [95%CI 2.98-10.70]）、I 型胶原 C 端交联肽（ICTP）（5.07 μg/L [95%CI 3.58-6.56]）和 I 型胶原 N 端交联肽（NTX）（5.08 nM 骨胶原当量/L [95%CI 2.82-7.33]）在 BM 患者中明显低于非 BM 患者。亚组分析发现，白种人 BM 患者的抗酒石酸酸性磷酸酶 5b 同工酶血清水平明显降低（-0.64 U/L [95%CI -1.02 至 -0.25]），而亚洲人 BM 患者的血清水平升高（2.69 U/L [95%CI 0.08-5.31]），与非 BM 患者相比。
本荟萃分析表明，TALP、BALP、ICTP 和 NTX 的血清测量可能有助于检测肺癌中的 BM。
