Abstract
BackgroundBone metastasis is relatively uncommon in gastric cancer patients, but its incidence has been rising. Early detection of bone metastasis is important in preventing complications related to bone metastasis such as pain, fracture and the compromise of chemotherapy. In this pilot study, we investigated the feasibility of bone turnover markers as surrogate markers of bone metastasis in gastric cancer patients.MethodsFifty-eight patients with gastric cancer were included in this study. Serum levels of bone alkaline phosphatase (ALP), parathyroid hormone (PTH), 25(OH) D, osteocalcin (OC) and C terminal telopeptide were measured and compared between patients with bone metastasis and those without. Student’s t-test and Mann-Whitney U test were used in comparing two groups, and Spearman’s rank order correlation coefficient was calculated to quantify the strength of the associations.ResultsFifty eight age- and sex-matched patients were evaluated for bone turnover markers, among whom 29 patients had bone metastasis and 29 patients with no bone metastasis. The median age was 62 and there were 20 (68.9 %) males and 9 (31.1 %) females in each group. Bone ALP was significantly higher in the patient group (57.32 ± 46.83 vs. 34.57 ± 21.57, P = 0.037) than control group. Bone ALP was positively associated with ALP, osteocalcin, CA19-9, CA 72–4 and negatively associated with 25(OH) D. According to ROC-curve analysis, at the threshold value of 29.60 μg/L, the sensitivity of bone ALP was 76.7 % and the specificity was 59.4 %.ConclusionBone ALP may be a surrogate marker of bone metastasis in gastric cancer patients. More prospective studies are warranted to determine the optimal bone turnover markers in the evaluation of bone metastasis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2415-x) contains supplementary material, which is available to authorized users.
Highlights
Bone metastasis is relatively uncommon in gastric cancer patients, but its incidence has been rising
The assessment of bone metastasis currently relies on imaging, and 99mTc-based bone scintigraphy is routinely used for the detection of bone metastasis [7]
Bone alkaline phosphatase (ALP) was positively associated with ALP, osteocalcin, CA19-9, CA72-4 and negatively associated with 25(OH) D
Summary
Bone metastasis is relatively uncommon in gastric cancer patients, but its incidence has been rising. Detection of bone metastasis is important in preventing complications related to bone metastasis such as pain, fracture and the compromise of chemotherapy. In this pilot study, we investigated the feasibility of bone turnover markers as surrogate markers of bone metastasis in gastric cancer patients. Lim et al BMC Cancer (2016) 16:385 involving osteoclast-mediated osteolysis and osteoblastmediated osteogenesis This may result in reduced bone integrity and skeletal complications such as fracture and severe bone pain may occur [6]. Early detection of bone metastasis in advanced cancer patients is important for treatment and prognosis. Bone scintigraphy is not largely recommended as routine evaluation for evidence of bone metastasis at the time of diagnosis or during treatment
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