Tähtelä R, Thölix E
United Laboratories Ltd, Helsinki, Finland.
Anticancer Res. 1996 Jul-Aug;16(4B):2289-93.
The most abundant protein in bone is type I collagen. During type I collagen formation two extension peptides from both ends of the procollagen molecule, carboxy- and aminoterminal propeptides (PICP and PINP), are liberated in equimolar concentrations into the circulation. Type I collagen carboxyterminal telopeptide (ICTP) is formed during bone collagen breakdown and is liberated into the circulation. Serum concentration of the propeptides reflect bone formation, and the concentration of the telopeptide, bone resorption. We evaluated the usefulness of these bone remodelling markers in diagnosing and monitoring metastatic bone disease in breast cancer patients. Serum concentrations of ICTP, PICP and PINP were measured and the PICP/PINP-ratio calculated in 25 patients with bone metastases, 12 patients without metastases and their age matched healthy controls. S-ICTP and S-PINP were significantly higher in metastatic patients (p = 0.0001 and 0.02 respectively), and the S-PICP/PINP-ratio lower (p = 0.002) than in controls. S-PICP in metastatic patients did not differ significantly from that of controls. ICTP values in patients without metastases also differed from those of controls (p = 0.01). The clinical sensitivity for diagnosing metastatic bone disease was 56% for ICTP, 24% for PICP, 30% for PINP and 52% for PICP/PINP ratio. The clinical specifities were 93%, 100%, 98% and 91% respectively. During follow-up the changes in the marker values were parallel to the behaviour of the disease. We conclude that these markers alone are not sensitive enough for diagnosis, but they seem to be of use in detecting bone metastases and monitoring the activity of bone disease.
骨骼中含量最丰富的蛋白质是I型胶原蛋白。在I型胶原蛋白形成过程中，前胶原分子两端的两个延伸肽，即羧基末端和氨基末端前肽（PICP和PINP），以等摩尔浓度释放到循环中。I型胶原蛋白羧基末端端肽（ICTP）在骨胶原分解过程中形成并释放到循环中。前肽的血清浓度反映骨形成，而端肽的浓度反映骨吸收。我们评估了这些骨重塑标志物在诊断和监测乳腺癌患者转移性骨病中的作用。测定了25例骨转移患者、12例无转移患者及其年龄匹配的健康对照者的血清ICTP、PICP和PINP浓度，并计算了PICP/PINP比值。转移性患者的S-ICTP和S-PINP显著高于对照组（分别为p = 0.0001和0.02），S-PICP/PINP比值低于对照组（p = 0.002）。转移性患者的S-PICP与对照组无显著差异。无转移患者的ICTP值也与对照组不同（p = 0.01）。ICTP诊断转移性骨病的临床敏感性为56%，PICP为24%，PINP为30%，PICP/PINP比值为52%。临床特异性分别为93%、100%、98%和91%。在随访期间，标志物值的变化与疾病的进展平行。我们得出结论，这些标志物单独用于诊断时敏感性不够，但它们似乎在检测骨转移和监测骨病活动方面有用。
