Kriteman L, Sanders W H
Division of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.
Urology. 1998 Mar;51(3):397-9. doi: 10.1016/s0090-4295(97)00618-3.
To determine the correlation between alkaline phosphatase levels and bone metastases in renal cell carcinoma.
The records of two cohorts, including 539 and 184 patients, with metastatic renal cell carcinoma were reviewed. In both groups, metastases were shown on magnetic resonance imaging (MRI), computed tomography (CT), or bone scan. In addition, the second cohort included data concerning pain on presentation. None of the patients in either cohort had any systemic therapy (chemotherapy or immunotherapy); many patients had undergone radical nephrectomy as the primary treatment of the cancer. All radiographic and laboratory information was obtained within a 6-week enrollment period. Normal alkaline phosphatase levels were referenced according to age and sex, resulting in an upper limit of normal of 111 to 141 U/L.
In the first cohort bone metastases were documented by MRI, CT, and/or bone scans in 164 patients. Alkaline phosphatase levels were less than or equal to 141 U/L in 118 patients (72%) and less than or equal to 111 U/L in 87 patients (53%). There were 123 patients with bone metastases who had previously undergone a nephrectomy for presumed local disease. Alkaline phosphatase levels were less than or equal to 141 U/L in 91 patients (74%) and less than or equal to 111 U/L in 70 patients (57%). In the second cohort 22 of 37 patients (59%) had little to no pain on presentation, and 19 (86%) of that group had normal alkaline phosphatase levels.
Alkaline phosphatase is an insensitive indicator of bone metastases.
确定肾细胞癌中碱性磷酸酶水平与骨转移之间的相关性。
回顾了两个队列中539例和184例转移性肾细胞癌患者的记录。在这两组中，磁共振成像（MRI）、计算机断层扫描（CT）或骨扫描均显示有转移。此外，第二个队列包括有关就诊时疼痛的数据。两个队列中的患者均未接受任何全身治疗（化疗或免疫治疗）；许多患者已接受根治性肾切除术作为癌症的主要治疗方法。所有影像学和实验室信息均在6周的入组期内获得。根据年龄和性别确定正常碱性磷酸酶水平，正常上限为111至141 U/L。
在第一个队列中，164例患者通过MRI、CT和/或骨扫描记录到骨转移。118例患者（72%）的碱性磷酸酶水平小于或等于141 U/L，87例患者（53%）的碱性磷酸酶水平小于或等于111 U/L。有123例骨转移患者此前因假定的局部疾病接受了肾切除术。91例患者（74%）的碱性磷酸酶水平小于或等于141 U/L，70例患者（57%）的碱性磷酸酶水平小于或等于111 U/L。在第二个队列中，37例患者中有22例（59%）就诊时几乎没有疼痛，该组中有19例（86%）碱性磷酸酶水平正常。
碱性磷酸酶是骨转移的不敏感指标。
