Francini G, Gonnelli S, Petrioli R, Bruni S, Marsili S, Aquino A, Camporeale A
Institute of Medical Pathology, University of Siena, Italy.
Cancer Epidemiol Biomarkers Prev. 1993 Mar-Apr;2(2):125-9.
Collagen type I is the sole collagen type found in bones and tendons. Carboxyterminal propeptide, deriving and cleaved from procollagen type I (PICP) during collagen synthesis, is delivered into the blood, where it can be measured. According to current knowledge, PICP correlates with bone collagen synthesis and bone formation rate. Elevated serum levels of PICP in patients with Paget's disease, compared with normal subjects and correlated with serum alkaline phosphatase (Alk.Ph.), have been previously described. Thus, PICP may be a valuable marker of bone formation. PICP, serum Alk.Ph., serum bone Gla protein and 24-h urinary hydroxyproline:creatinine ratio have been measured in 47 cancer patients: 27 with predominantly osteolytic lesions (5 myeloma, 15 breast, 3 lung, 2 kidney, 1 bladder, 1 thyroid) and 20 with predominantly osteoblastic lesions (18 prostate and 2 breast). The higher levels of PICP were noted in patients with osteoblastic or mixed metastases. In the entire group of patients, a statistically significant correlation between PICP and bone Gla protein (r = 0.57; P < 0.001), PICP and Alk.Ph. (r = 0.80; P < 0.001), and bone Gla protein and Alk.Ph. (r = 0.44; P < 0.01) was noted. In those patients with osteoblastic metastases we observed a significant correlation only between PICP and Alk.Ph. (r = 0.62; P < 0.003). During chemotherapy, 13 of 20 patients with osteoblastic metastases who achieved objective response or stable disease showed a more rapid and significant decrease in PICP with respect to the other bone markers. Serum PICP level could be considered a good marker of osteoblastic activity.
I型胶原是骨骼和肌腱中唯一发现的胶原类型。羧基末端前肽在胶原合成过程中从I型前胶原衍生并裂解，进入血液后可进行测量。根据目前的知识，PICP与骨胶原合成和骨形成率相关。先前已描述，与正常受试者相比，佩吉特病患者血清PICP水平升高，并与血清碱性磷酸酶（Alk.Ph.）相关。因此，PICP可能是骨形成的一个有价值的标志物。对47例癌症患者测量了PICP、血清Alk.Ph.、血清骨钙素和24小时尿羟脯氨酸：肌酐比值：27例主要为溶骨性病变（5例骨髓瘤、15例乳腺癌、3例肺癌、2例肾癌、1例膀胱癌、1例甲状腺癌），20例主要为成骨性病变（18例前列腺癌和2例乳腺癌）。成骨性或混合性转移患者的PICP水平较高。在整个患者组中，观察到PICP与骨钙素（r = 0.57；P < 0.001）、PICP与Alk.Ph.（r = 0.80；P < 0.001）以及骨钙素与Alk.Ph.（r = 0.44；P < 0.01）之间存在统计学显著相关性。在那些有成骨性转移的患者中，我们仅观察到PICP与Alk.Ph.之间存在显著相关性（r = 0.62；P < 0.003）。在化疗期间，20例有成骨性转移且达到客观缓解或病情稳定的患者中，有13例相对于其他骨标志物，PICP下降更快且更显著。血清PICP水平可被视为成骨活性的良好标志物。
