Bone-turnover metabolites as clinical markers of bone metastasis in patients with prostatic carcinoma.

BACKGROUND

Candidate markers of prostatic metastases to bone, urinary deoxypyridinoline, serum carboxy-terminal propeptide of type 1 procollagen (P1CP), and pyridinoline cross-linked carboxy-terminal telopeptide of type 1 collagen (1CTP), were measured to evaluate their prognostic efficacy.

METHODS

Urinary levels (mean +/- SD) of deoxypyridinoline were measured by a competitive immunoassay, and serum levels of P1CP and 1CTP were measured by radioimmunoassay in 30 patients with benign prostatic hyperplasia, 18 patients with prostatic carcinoma without bone metastases, and 27 patients with prostatic carcinoma and bone metastases.

RESULTS

Urinary concentrations of deoxypyridinoline (pmol/micromol creatinine) in patients with prostatic carcinoma and bone metastases (10.4 +/- 7.7) were significantly higher than those in similar patients without bone metastases (4.3 +/- 1.3) and those in patients with benign prostatic hyperplasia (3.8 +/- 1.2). Serum levels of P1CP and 1CTP (ng/mL) in patients with prostatic carcinoma and bone metastases (262.6 +/- 188.7 and 10.3 +/- 9.5, respectively) were significantly higher than those in similar patients without bone metastases (118.1 +/- 30.2 and 4.3 +/- 1.4, respectively) and those in patients with benign prostatic hyperplasia (93.9 +/- 25.1 and 3.3 +/- 1.1, respectively). Serial measurements of urinary deoxypyridinoline and serum P1CP and 1CTP were correlated with a positive response to treatment (reduced measurements) and with the clinical progression of disease (increased measurements) before detection of new bone lesions by bone scintigram.

CONCLUSION

Urinary deoxypyridinoline, serum P1CP, and serum 1CTP should be useful markers in confirming and monitoring prostatic carcinoma metastases to bone.