摘要
目的:探讨骨代谢生化指标血清Ⅰ型胶原交联氨基末端肽(N-telopeptide of typeⅠcollagen,NTx)和骨涎酸蛋白(bone sialoprotein,BSP)的检测对肺癌和乳腺癌骨转移的临床意义。方法:选择2006年1月至2006年7月长海医院肿瘤科经病理确诊的肺癌或乳腺癌患者105例,分为两组,其中骨转移组50例,无骨转移组55例。应用ELISA法检测患者血清NTx和BSP浓度。结果:骨转移组患者血清NTx和BSP水平均明显高于无骨转移组(P<0.01)。NTx诊断骨转移的灵敏度和特异度分别为90.0%和67.3%,BSP诊断骨转移的灵敏度和特异度分别为84.0%和70.9%。临床发生骨相关事件(skeletal related event,SRE)的骨转移患者,血清NTx水平明显高于未发生SRE的骨转移患者(P<0.05)。在6～13个月随访期内,21例患者确诊了新发骨转移;采用Cox比例风险回归模型分析,血清NTx浓度升高提示骨转移发生的相对危险度为1.127;乳腺癌患者血清BSP增高是唯一预测骨转移的危险因素(P<0.05),其相对危险度为1.058。随访期共有33例患者死亡;无论肺癌还是乳腺癌,血清BSP增高患者的累积生存率均明显低于血清BSP正常组(P<0.05)。结论:血清NTx和BSP是诊断肺癌和乳腺癌骨转移的重要参考指标,其水平的增高是预测骨转移发生的高危因素;BSP可能是肺癌和乳腺癌患者独立预后指标。
Objective： To study the clinical significance of examining serum pyridinoline cross-linked N-telopeptides of type Ⅰ collagen （NTx） and serum bone sialoprotein （BSP） in diagnosing bone metastasis of lung cancer and breast cancer. Methods：A total of 105 patients treated in the Oneology Department of Changhai Hospital were included in this study. Patients were divided into 2 groups ： bone metastasis （ n = 50） and non-bone metastasis groups （ n = 55）. The levels of serum NTx and serum BSP were measured by ELISA. Results： The levels of serum NTx and serum BSP in patients with bone metastasis were significantly higher than in those without bone metastasis （P 〈 0. 01 ）. The sensitivity and specificity of serum NTx in the diagnosis of bone metastasis were 90.0% and 67.3% , respectively; the sensitivity and specificity of serum BSP were 84.0% and 70.9% , respectively. Thirty-two patients with bone metastases had skeletal related events （SRE） and they also had significantly higher levels of serum NTx （P 〈 0.05）. During the follow-up, 21 patients were diagnosed with new-onset of bone metastasis. COX anlysis showed that the relative risk ratio for bone metastasis of higher serum NTx level was 1. 127. Further analysis showed that serum BSP was the only risk factor for patients with breast cancer to develop bone metastasis （P 〈 0.01 ）, with the relative risk ratio being 1. 058. During the follow-up 33 patients died. The cumulative survival rate of patients with higher serum BSP was lower than that with normal serum BSP level. Conclusion ： The serum NTx and BSP were important biomarkers for diagnosis of bone metastasis. The two markers can be regarded as risk factors for bone metastasis. BSP might be an independent factor for predicting the prognosis of lung and breast cancer.
出处
《中国肿瘤生物治疗杂志》
CAS
CSCD
2008年第5期478-483,共6页
Chinese Journal of Cancer Biotherapy
基金
上海市科委科技基金资助项目( No.06DZ19505)~~
关键词
Ⅰ型胶原交联氨基末端肽
骨涎酸蛋白
肺癌
乳腺癌
骨转移
诊断
预后
N-telopeptides of type Ⅰ collagen
bone sialoprotein
lung neoplasms
breast neoplasms
bone metastasis
diagnosis
prognosis
