Kamby C, Egsmose C, Söletormos G, Dombernowsky P
Department of Oncology R, Herlev Hospital, University of Copenhagen, Denmark.
Scand J Clin Lab Invest. 1993 Aug;53(5):439-46. doi: 10.1080/00365519309092538.
Serum bone Gla protein (S-BGP), a marker of bone metabolism, was measured in 60 patients included in a staging programme for recurrent breast cancer. Other diagnostic procedures comprised S-alkaline phosphatase (S-AP), bone scan (B-scan), bilateral iliac crest bone marrow biopsies, and radiological bone survey. The sites of recurrence were bone (61%), bone marrow (46%), soft tissue (52%), lung (13%), pleura (11%), liver (4%), and brain (2%). Radiology and bone biopsy served as key diagnoses as to the presence or absence of bone metastases. The diagnostic efficiency of B-scan and S-AP was greater than that of S-BGP, and the result of BGP measurement was associated with neither extent nor number of bone metastases. However, the BGP values were significantly lower in patients who had visceral metastases, and the median duration of survival after recurrence was 13 months for patients with low S-BGP levels (= < 2.0 nmol l-1), compared to 18 months for patients with medium S-BGP values (2.0-2.9 nmol l-1), and 25 months for patients with high values (> 3.0 nmol l-1) (p = 0.19). Analyses of the simultaneous effect of univariate prognostic factors were performed using the Cox proportional hazards model. S-alkaline phosphatase (S-AP) and S-BGP were the only significant, independent prognostic factors.
血清骨钙素（S-BGP）是一种骨代谢标志物，在60例复发性乳腺癌分期项目的患者中进行了检测。其他诊断程序包括血清碱性磷酸酶（S-AP）、骨扫描（B扫描）、双侧髂嵴骨髓活检和放射学骨检查。复发部位为骨（61%）、骨髓（46%）、软组织（52%）、肺（13%）、胸膜（11%）、肝（4%）和脑（2%）。放射学检查和骨活检是诊断是否存在骨转移的关键。B扫描和S-AP的诊断效率高于S-BGP，BGP测量结果与骨转移的范围和数量均无关。然而，内脏转移患者的BGP值显著较低，S-BGP水平低（= < 2.0 nmol l-1）的患者复发后的中位生存期为13个月，S-BGP值中等（2.0 - 2.9 nmol l-1）的患者为18个月，S-BGP值高（> 3.0 nmol l-1）的患者为25个月（p = 0.19）。使用Cox比例风险模型对单变量预后因素的同时效应进行了分析。血清碱性磷酸酶（S-AP）和S-BGP是仅有的显著独立预后因素。
