Abstract
Background: This study investigated the usefulness of bone markers Alkaline Phosphatase (AP) and Beta- Crosslaps (s-CTx) to diagnose, treat and monitor patients with breast carcinoma. AP is a marker of bone formation, while s-CTx are markers of bone resorption. s-CTx are expressed as degradation products of collagen type I and can be measured in blood and urine. Objectives: The aim of this project was to evaluate the significance of bone markers s-CTx and AP with regard to their usage for early diagnostics of bone metastases and pathological bone metabolism in pre- and postmenopausal patients with known breast cancer. Materials and Methods: Peripheral blood samples of patients with mammarial diseases (benign and malign) were collected and the bone markers AP and s-CTx determined. A total number of 110 patients had benign mammarial diseases, BMD (30 fibroadenoma, 50 mastopathy and 30 hypertrophy patients). 30 patients were suffering from a malignant breast cancer without bone metastases. 50 patients had known bone metastases. The determination of s-CTx was conducted based on the Immunoassay “ECLIA”, the analysis approach Elecsys 2010 and cobase by Roche Diagnostics (Mannheim, Germany). The analysis of AP was performed with the HYDRAGEL ISO-PAL kits and HYDRASYS electrophoresis system of Sebia (Fulda, Germany). Results: For the detection of bone metastases, the study showed a sensitivity of 94.0% with 86.67% specificity for AP. Results for s-CTx had a sensitivity and specificity of 100.0%. An elevated s-CTx activity was associated significantly with bone metastases in the study groups (p=0.000000). Furthermore there were significant differences (p=0.000000) due to the menopausal status of patients. Conclusion: In conclusion s-CTx are more sensitive and specific to detect bone metastases and bone turnover than AP. In patients with multimorbidity the origin of AP is not clear due to its multi-organic appearance. Hence s- CTx are considered to be helpful in the diagnostic procedure of breast cancer-patients to detect bone metastases. Moreover they can be utilized to indicate patients with early dysfunctions in bone metabolism and allow inducing early treatment. s-CTx as indicators of bone resorption are capable to provide a significant differentiation between mamma-carcinoma patients with and without bone affection.
Highlights
Breast cancer and metastases induced by this disease are topics of medical research through decades
SSCTx are considered to be helpful in the diagnostic procedure of breast cancer-patients to detect bone metastases
They can be utilized to indicate patients with early dysfunctions in bone metabolism and allow inducing early treatment. ß-CTx as indicators of bone resorption are capable to provide a significant differentiation between mamma-carcinoma patients with and without bone affection
Summary
Breast cancer and metastases induced by this disease are topics of medical research through decades. Bone is a typical location for metastases which often increase pain, morbidity and mortality. The accurate diagnostic of bone metastases and early induced antiresorptive/ cancer therapies are essential to reduce morbidity and mortality. Bone is resorbed by osteoclasts rather than through the tumor cells [1,2,3,4]. Under these circumstances bone turnover is elevated and some of the involved enzymes and metabolic products can be measured. This study investigated the usefulness of bone markers Alkaline Phosphatase (AP) and BetaCrosslaps (ß-CTx) to diagnose, treat and monitor patients with breast carcinoma. AP is a marker of bone formation, while ß-CTx are markers of bone resorption. AP is a marker of bone formation, while ß-CTx are markers of bone resorption. ß-CTx are expressed as degradation products of collagen type I and can be measured in blood and urine
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