Wada S, Katayama Y, Yasutomo Y, Kugai N, Nagata N
Third Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Intern Med. 1993 Aug;32(8):611-8. doi: 10.2169/internalmedicine.32.611.
To determine the changes in bone metabolism in response to combined chemotherapy in patients with bone metastases (BM), we examined osteocalcin (BGP), alkaline-phosphatase (ALP), hydroxyproline (HYP), pyridinoline (PYR), and/or deoxypyridinoline (D-PYR) in 25 cancer patients. In patients without BM, serum BGP was normal and not affected by chemotherapy. In patients with BM, however, BGP was often abnormally high or low, and some patients reacted to chemotherapy with a BGP increase at 4 weeks after initiation of therapy. Such an increase was observed in the group of patients who responded favorably to therapy as judged by a decrease in bone pain and tumor-associated biochemical markers. Urine HYP, PYR, and D-PYR were high in patients with BM before therapy; D-PYR decreased transiently at 2 weeks and increased thereafter. We assume that increased bone-resorption markers along with increased bone formation markers after therapy would indicate recovery of coupled bone metabolism, as the deranged bone remodeling is improved by tumor-regression. This study suggests that BGP and D-PYR can be useful early markers to predict favorable bone response to chemotherapy in patients with BM.
为了确定骨转移（BM）患者在联合化疗后骨代谢的变化，我们检测了25例癌症患者的骨钙素（BGP）、碱性磷酸酶（ALP）、羟脯氨酸（HYP）、吡啶啉（PYR）和/或脱氧吡啶啉（D-PYR）。在无骨转移的患者中，血清BGP正常，且不受化疗影响。然而，在有骨转移的患者中，BGP常异常升高或降低，一些患者在治疗开始后4周时对化疗反应为BGP升高。在那些根据骨痛和肿瘤相关生化标志物降低判断对治疗反应良好的患者组中观察到了这种升高。治疗前，骨转移患者的尿HYP、PYR和D-PYR水平较高；D-PYR在2周时短暂下降，之后升高。我们认为，治疗后骨吸收标志物增加以及骨形成标志物增加表明耦合骨代谢恢复，因为紊乱的骨重塑通过肿瘤消退得到改善。本研究表明，BGP和D-PYR可作为预测骨转移患者对化疗有良好骨反应的早期有用标志物。
