血清Ⅰ型前胶原氨基端前肽与Ⅰ型胶原羧基端肽β特殊序列在恶性肿瘤骨转移诊断和病情评估及疗效评价中的应用价值  

Applied values of serum N-terminal propeptide of typeⅠprecollagen and β cross-linked C-telopeptide of typeⅠcollagen in diagnosis,severity assessment and therapeutic efficacy evaluation of bone metastasis of malignant tumors

作　　者：朱丽英[1] 胡春艳[1] 贠春燕 李晓利 ZHU Liying;HU Chunyan;YUN Chunyan;LI Xiaoli(The Second Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China)

机构地区：[1]河南科技大学第二附属医院,河南洛阳471000

出　　处：《中医正骨》2018年第6期30-33,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨血清Ⅰ型前胶原氨基端前肽(N-terminal propeptide of typeⅠprecollagen,PⅠNP)与Ⅰ型胶原羧基端肽β特殊序列(βcross-linked C-telopeptide of typeⅠcollagen,β-CTX)在恶性肿瘤骨转移诊断、病情评估及疗效评价中的应用价值。方法:回顾性分析2015年3月至2017年3月收治的115例恶性肿瘤患者的临床资料。根据肿瘤是否出现骨转移分为骨转移组和无骨转移组,根据骨转移数目将骨转移组分为骨转移数目<3个组和骨转移数目≥3个组,根据世界卫生组织实体瘤近期疗效评价标准中的骨转移评价标准将骨转移组分为治疗有效组和治疗无效组。比较治疗前骨转移组和无骨转移组,骨转移数目<3个组和骨转移数目≥3个组的血清PⅠNP和β-CTX含量,以及骨转移组治疗前后的血清PⅠNP和β-CTX含量。结果:骨转移组48例,无骨转移组67例,骨转移组的血清PⅠNP和β-CTX含量均高于无骨转移组[(110.31±15.67)ng·m L^(-1),(45.56±8.65)ng·m L^(-1),t=3.146,P=0.002;(0.58±0.02)ng·m L^(-1),(0.36±0.01)ng·m L^(-1),t=2.858,P=0.005]。骨转移数目<3个组21例,骨转移数目≥3个组27例,骨转移数目<3个组的血清PⅠNP和β-CTX含量均低于骨转移数目≥3个组[(102.41±12.34)ng·m L^(-1),(116.45±17.48)ng·m L^(-1),t=3.121,P=0.003;(0.56±0.01)ng·m L^(-1),(0.58±0.04)ng·m L^(-1),t=2.058,P=0.045]。48例骨转移患者中,42例针对原发肿瘤进行了化疗和放疗,并应用了双磷酸盐药物治疗;其余6例均采用镇痛药物进行姑息治疗。治疗2个月后,治疗有效34例、无效14例,治疗有效组的血清PⅠNP和β-CTX含量均较治疗前下降[(97.14±17.32)ng·m L^(-1),(105.77±15.04)ng·m L^(-1),t=9.890,P=0.000;(0.52±0.03)ng·m L^(-1),(0.57±0.02)ng·m L^(-1),t=11.655,P=0.000],治疗无效组的血清PⅠNP和β-CTX含量与治疗前相比差异均无统计学意义[(118.24±20.42)ng·m L^(-1),(121.31±16.30)ng·m L^(-1),t=1.815,P=0.093;(0.59±0.04)ng·m L^(-1),(0.60±0.03)ng·m L^(-1),t=0.7Objective： To explore the applied values of serum N-terminal propeptide of type Ⅰ precollagen（ P Ⅰ NP） and β cross-linked C-telopeptide of typeⅠcollagen（ β-CTX） in diagnosis,severity assessment and therapeutic efficacy evaluation of bone metastasis of malignant tumors. Methods： The medical records of 115 patients with malignant tumors recruited from March 2015 to March 2017 were analyzed retrospectively. The patients were divided into bone metastasis group and non-bone metastasis group according to whether bone metastases of malignant tumor were found. The patients in bone metastasis group were divided into 3 subgroup and≥3 subgroup according to the number of bone metastases and effective treatment group and ineffective treatment group according to the evaluation criteria for bone metastasis which was extracted from short-term efficacy evaluation criteria for solid tumors issued by World Health Organization（ WHO）.The serum contents of PⅠNP and β-CTX were compared between bone metastasis group and non-bone metastasis group and between bone metastasis number of 3 subgroup and bone metastasis number of≥3 subgroup before the treatment,moreover,the serum contents of PⅠNP and β-CTX were compared between pre-treatment and post-treatment in bone metastasis group. Results： The serum contents of PⅠNP and β-CTX were higher in bone metastasis group（ 48 cases） compared to non-bone metastasis group（ 67 cases）（ 110. 31 ＋/-15. 67 vs 45. 56 ＋/-8. 65 ng/m L,t = 3. 146,P = 0. 002; 0. 58 ＋/-0. 02 vs 0. 36 ＋/-0. 01 ng/m L,t = 2. 858,P = 0. 005）. The serum contents of PⅠNP and β-CTX were lower in bone metastasis number of 3 subgroup（ 21 cases） compared to bone metastasis number of≥3 subgroup（ 27 cases）（ 102. 41 ＋/-12. 34 vs 116. 45 ＋/-17. 48 ng/m L,t = 3. 121,P = 0. 003; 0. 56 ＋/-0. 01 vs 0. 58 ＋/-0. 04 ng/m L,t =2. 058,P = 0. 045）. Forty-two out of 48 patients with bone metastases were treated with chemotherapy and radiotherapy aiming at primary tumor

关 键 词：肿瘤转移 骨肿瘤 Ⅰ型前胶原氨基端前肽 Ⅰ型胶原羧基端肽β特殊序列 

分 类 号：R73-37[医药卫生—肿瘤]