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Value of C-telopeptide-cross-linked Type I collagen, osteocalcin, bone-specific alkaline phosphatase and procollagen Type I N-terminal propeptide in the diagnosis and prognosis of bone metastasis in patients with malignant tumors.

Zhao H, Han KL, Wang ZY, Chen Y, Li HT, Zeng JL, Shen Z, Yao Y - Med. Sci. Monit. (2011)

Bottom Line: In addition, CTX of >547 ng/ml had the highest sensitivity and OST of >20.34 ng/ml the highest specificity in the non-metastasis group.Furthermore, both B-ALP of >15.55 ng/ml had relatively high negative predictive value and positive predictive value.CTX had a high sensitivity, and PINP had a high specificity in predicting bone metastasis.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Oncology, Sixth People's Hospital, Shanghai JiaoTong University, Shanghai, China.

ABSTRACT

Background: Studies show markers of bone turnover can help the clinician in the diagnosis and follow-up of bone metastases. The present study aimed to investigate the value of biochemical markers of bone turnover in the diagnosis and prognosis of bone metastases of malignant tumors.

Material/methods: The serum levels of C-Telopeptide-Cross-Linked Type I Collagen (CTx), Procollagen Type I N-Terminal Propeptide (PINP), Bone-Specific Alkaline Phosphatase (B-ALP) and Osteocalcin (OST) in patients with bone metastases and control subjects were measured using radioimmunoassay and immunochemiluminescent assay.

Results: The levels of CTx, PINP, B-ALP and OST in the metastasis group were significantly higher than those in both control groups and correlated with the number of bone metastatic sites. The levels of these markers were higher in prostate cancer patients with bone metastasis. The CTX of >426 ng/ml had the highest sensitivity and NPV, and PINP of >51.21 ng/ml had the highest specificity and PPV in healthy subjects. In addition, CTX of >547 ng/ml had the highest sensitivity and OST of >20.34 ng/ml the highest specificity in the non-metastasis group. Furthermore, both B-ALP of >15.55 ng/ml had relatively high negative predictive value and positive predictive value.

Conclusions: Biochemical markers of bone turnover, including CTx, PINP, B-ALP and OST, play important roles in the diagnosis and prognosis of metastatic bone cancer. CTX had a high sensitivity, and PINP had a high specificity in predicting bone metastasis. B-ALP is an ideal biochemical marker of bone turnover for metastatic bone cancer.

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ROC cruves of B-ALP, CTX, OST and PINP.
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f1-medscimonit-17-11-cr626: ROC cruves of B-ALP, CTX, OST and PINP.

Mentions: The cut-off curve was used to analyze the sensitivity and specificity of each bone metabolic marker – “1” represents cancer patients without metastasis and “2” represents healthy controls. When compared with patients without metastasis, the CTX had the highest sensitivity and PINP had the highest specificity. When compared with healthy controls, CTX had the highest sensitivity and OST had the highest specificity (Table 6, Figure 1). According to the receiver operating characteristic (ROC) curve, the cut-off value of each marker was obtained, based on which the specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. As shown in Table 6, in healthy subjects CTX of >426 ng/ml had the highest sensitivity and NPV, PINP of >51.21 ng/ml had the highest specificity and PPV. In the non-metastasis group, CTX of >547 ng/ml had the highest sensitivity, OST of >20.34 ng/ml had the highest specificity, and B-ALP of >15.55 ng/ml had the highest NPV and PPV. Therefore, CTX was considered as a sensitive biochemical marker of bone turnover and PINP was considered as a specific marker. Based on the NPV and PPV, B-ALP may be an ideal marker of bone metabolism.


Value of C-telopeptide-cross-linked Type I collagen, osteocalcin, bone-specific alkaline phosphatase and procollagen Type I N-terminal propeptide in the diagnosis and prognosis of bone metastasis in patients with malignant tumors.

Zhao H, Han KL, Wang ZY, Chen Y, Li HT, Zeng JL, Shen Z, Yao Y - Med. Sci. Monit. (2011)

ROC cruves of B-ALP, CTX, OST and PINP.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539492&req=5

f1-medscimonit-17-11-cr626: ROC cruves of B-ALP, CTX, OST and PINP.
Mentions: The cut-off curve was used to analyze the sensitivity and specificity of each bone metabolic marker – “1” represents cancer patients without metastasis and “2” represents healthy controls. When compared with patients without metastasis, the CTX had the highest sensitivity and PINP had the highest specificity. When compared with healthy controls, CTX had the highest sensitivity and OST had the highest specificity (Table 6, Figure 1). According to the receiver operating characteristic (ROC) curve, the cut-off value of each marker was obtained, based on which the specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. As shown in Table 6, in healthy subjects CTX of >426 ng/ml had the highest sensitivity and NPV, PINP of >51.21 ng/ml had the highest specificity and PPV. In the non-metastasis group, CTX of >547 ng/ml had the highest sensitivity, OST of >20.34 ng/ml had the highest specificity, and B-ALP of >15.55 ng/ml had the highest NPV and PPV. Therefore, CTX was considered as a sensitive biochemical marker of bone turnover and PINP was considered as a specific marker. Based on the NPV and PPV, B-ALP may be an ideal marker of bone metabolism.

Bottom Line: In addition, CTX of >547 ng/ml had the highest sensitivity and OST of >20.34 ng/ml the highest specificity in the non-metastasis group.Furthermore, both B-ALP of >15.55 ng/ml had relatively high negative predictive value and positive predictive value.CTX had a high sensitivity, and PINP had a high specificity in predicting bone metastasis.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Oncology, Sixth People's Hospital, Shanghai JiaoTong University, Shanghai, China.

ABSTRACT

Background: Studies show markers of bone turnover can help the clinician in the diagnosis and follow-up of bone metastases. The present study aimed to investigate the value of biochemical markers of bone turnover in the diagnosis and prognosis of bone metastases of malignant tumors.

Material/methods: The serum levels of C-Telopeptide-Cross-Linked Type I Collagen (CTx), Procollagen Type I N-Terminal Propeptide (PINP), Bone-Specific Alkaline Phosphatase (B-ALP) and Osteocalcin (OST) in patients with bone metastases and control subjects were measured using radioimmunoassay and immunochemiluminescent assay.

Results: The levels of CTx, PINP, B-ALP and OST in the metastasis group were significantly higher than those in both control groups and correlated with the number of bone metastatic sites. The levels of these markers were higher in prostate cancer patients with bone metastasis. The CTX of >426 ng/ml had the highest sensitivity and NPV, and PINP of >51.21 ng/ml had the highest specificity and PPV in healthy subjects. In addition, CTX of >547 ng/ml had the highest sensitivity and OST of >20.34 ng/ml the highest specificity in the non-metastasis group. Furthermore, both B-ALP of >15.55 ng/ml had relatively high negative predictive value and positive predictive value.

Conclusions: Biochemical markers of bone turnover, including CTx, PINP, B-ALP and OST, play important roles in the diagnosis and prognosis of metastatic bone cancer. CTX had a high sensitivity, and PINP had a high specificity in predicting bone metastasis. B-ALP is an ideal biochemical marker of bone turnover for metastatic bone cancer.

Show MeSH
Related in: MedlinePlus