Background: Bone metastasis is common in lung cancer patients. The β isomer of the C-terminal telopeptide of type I collagen (β-CTX) and bone-specific alkaline phosphates (BAP) are regarded as important bone turnover markers in bone resorption and formation. Thus, the aims of this study are to determine the correlation of these bone turnover markers with the extent of bone metastasis of lung cancer.
Methods: A total of 92 patients with bone metastasis of lung cancer from Tianjin Union Medicine Center were enrolled in this study between July 2009 and July 2012. The bone metastasis lesion was diagnosed by ECT combined with X-ray and CT imaging. The bone turnover marker levels of β-CTX and BAP were measured by ELISA.
Results: Among the 92 patients, 58 cases had <3 bone-metastasis number and 34 had ≥3; 68 cases had osteolytic bone metastasis, 9 had osteoblastic bone metastasis, and 15 had mixed bone metastases. The serum levels of β-CTX and BAP were significantly higher in patients with >3 bone-metastasis number than that in patients with less than 3 (P<0.05). β-CTX was more sensitive than BAP in diagnosing lytic bone metastasis.
Conclusions: β-CTX and BAP can be used as supplementary tools for diagnosing and screening bone metastasis of lung cancer.
背景与目的: 肺癌易发生骨转移，Ⅰ型胶原羧基端肽β特殊序列（β isomer of C-terminal telopeptide of type Ⅰ collagen, β-CTX）和骨源性碱性磷酸酶（bone-specific alkaline phosphates, BAP）在骨质代谢中是重要的生化标记物，本研究旨在探讨骨代谢生化指标和肺癌骨转移进展程度的相关性，有助于早期判断是否有肺癌骨转移的发生。
方法: 天津市人民医院2009年7月-2012年7月共收治92例肺癌并发生骨转移患者，全部病例其原发灶均经细胞学检查证实，骨转移灶的数目及类型经ECT结合X线片、CT证实，采用ELISA方法检测血β-CTX、BAP的浓度水平。
结果: 收集的92例肺癌伴骨转移的患者中，转移灶 < 3处为58例，≥3处为34例；溶骨型68例，成骨型9例，混合型15例。血β-CTX、BAP水平在不同的骨转移数目组间差异有统计学意义（P < 0.05），β-CTX在肺癌溶骨型骨转移患者中具有较高的敏感性。
结论: 骨代谢生化指标β-CTX、BAP对肺癌骨转移具有辅助诊断意义，是判断转移进展程度的良好指标。