骨代谢标志物CTx、OST、BAP和PINP在乳腺癌骨转移患者血清中的变化  

The value analysis of bone metabolic markers CTx,OST,BAP and PINP for bone metastases in breast cancer patients

作　　者：赵晖[1] 王智煜[1] 杨玉妹[1] 郑研[2] 宁琳琳[2] 李洪涛[1] 姚阳[1] 

机构地区：[1]上海交通大学附属第六人民医院肿瘤内科,上海200233 [2]苏州大学医学院,江苏苏州215131

出　　处：《中国癌症杂志》2012年第6期469-473,480,共6页China Oncology

基　　金：上海市卫生局课题(No:2009086)

摘　　要：背景与目的:肿瘤骨转移时细胞因子作用于成骨和破骨细胞,破坏正常的骨代谢机制,导致骨代谢指标在恶性肿瘤骨转移中发生变化。本研究旨在探讨骨代谢标志物在乳腺癌骨转移患者血清中的变化,以期寻找较为可靠的临床随访指标。方法:收集51例乳腺癌骨转移患者,47例乳腺癌无骨转移患者及44例正常对照者的血清,采用放射免疫法和酶联免疫分析方法检测血清中Ⅰ型胶原羧基末端肽(β-C-terminaltelopeptide of typeⅠcollagen,CTx)、骨钙素(osteocalcin,OST)和骨特异性碱性磷酸酶(bone-specificalkaline phosphatase,BAP)及Ⅰ型胶原氨基端前肽(procollagen typeⅠN-terminal propeptide,PINP)的数值。结果:在乳腺癌骨转移组,CTx、OST、BAP和PINP的数值较对照组明显升高。各骨代谢指标与骨破坏性质、骨转移数量无明显相关。乳腺癌骨转移患者中位总生存时间为42.90个月,95%CI为38.02～47.78个月。中位骨转移发病时间(自确诊乳腺癌起)为63.65个月,95%CI为37.26～90.43个月。结论:CTx、OST、BAP和PINP的数值在乳腺癌骨转移组中明显升高,可作为临床随访的参考指标。Background and purpose： The tumor cell of bone metastases in cancer produces cell factors in the role of the osteoblast and osteoclast, destroying the normal bone metabolism mechanism, cause bone metabolism index changes. To investigate the value of quantitative measurement of bone metabolism relevant markers in bone metastases of breast cancer ,which is collagen type I C-telopeptide （CTx）, procollagen type Ⅰ N-terminal propeptide （PINP）, bone specific alkaline phosphatase （BAP）, and osteocalcin （OST）. Methods： Collect serums of 51 cases breast cancer with bone metastases, 47 cases breast cancer without bone metastases and 44 normal controls. The blood concentrations of CTx, PINP, BAP and OST in patients with bone metastases and in control subjects were measured using radioimmunoassay and immunochemiluminescent assay. Results： The levels of CTx, PINP, BAP and OST increased significantly in the bone metastasis group. Results showed that there were no significant correlations between factors such as the number and nature of the bone metastases cancer and bone metabolic markers. The median survival time was 42.90 months （95%CI： 38.02-47.78 months） for 51 patients until the end of follow-up. Time of onset of bone metastasis （since the diagnosis of breast cancer） was 63.65 month （95%CI： 37.26-90.43 months）after the diagnosis of breast cancer. Conclusion： The value of bone metabolic markers CTx, PINP, BAP and OST were significantly higher in breast cancer patients with bone metastases, which can be used as reference index of clinical follow-up.

关 键 词：乳腺癌 骨转移 骨钙素 骨碱性磷酸酶 Ⅰ型前胶原氨基末端前肽 Ⅰ型胶原羧基末端肽 

分 类 号：R737.9[医药卫生—肿瘤]