Abstract
Objective To investigate the diagnosis, therapeutic monitoring and prognosis value of the total procollagen type 1 amino-terminal propeptide (tP1NP), beta-C-terminal telopeptide (β-CTx) and bone alkaline phosphatase (BAP) in the bone metastasis of lung cancer. Methods With the case-control study method, the serum levels of tP1NP, β-CTx and BAP in 196 lung cancer patients, including 109 patients with bone metastases, 87 patients without bone metastases, and 106 healthy controls at the Shanghai Sixth People′s East Hospital affiliated to Shanghai Jiao Tong University between 2014 and 2015 were quantitatively detected by chemiluminescent immunoassay. Receiver operating characteristic (ROC) curve was calculated to assess the diagnostic value. Survival curve was performed by Kaplan-Meier method. Results The concentration of tP1NP, β-CTx and BAP in the lung cancer patients with bone metastasis were significantly higher than that in the lung cancer patients without bone metastasis (Z=-5.642, P<0.001; Z=-3.783, P<0.01; Z=-8.923, P<0.01). ROC curve analysis showed that the AUC of tP1NP, β-CTx and BAP were 0.874, 0.776 and 0.678 respectively(P<0.05). The AUC of the combined three markers was 0.925(95% CI 0.867-0.963), with sensitivity of 77.11% and specificity of 98.11%. The levels of tP1NP and β-CTx were associated with the clinical response. The concentration of tP1NP, β-CTx were significantly decreased in patients achieved remission(t=4.607, P<0.05; t=5.355, P<0.05). Survival analysis showed that higher concentration of tP1NP was correlated with poor prognosis[OR=3.287, 95% CI (1.118-9.661), P<0.05]. Conclusions The levels of tP1NP, β-CTx and BAP cloud be used for the differential diagnosis of bone metastasis of lung cancer, and the combined usage was more effective. tP1NP and β-CTx cloud be used in therapeutic monitoring of lung cancer patients with bone metastasis. Moreover, tP1NP could be used as prognostic biomarker in lung cancer patients.(Chin J Lab Med, 2017, 40: 860-864) Key words: Lung neoplasms; Bone neoplasms; Neoplasm metastasis; Peptide fragments; Procollagen; Alkaline phosphatase
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