Abstract
In 181 consecutive patients with breast cancer, urinary hydroxyproline excretion has been critically evaluated in conjunction with clinical, biochemical, radiological and scintigraphic parameters. The urinary hydroxyproline/creatinine ratio is a sensitive index of the presence of bone metastases. Urinary hydroxyproline excretion is a reliable method of selecting those patients whose elevated serum alkaline phosphatase is secondary to bone disease rather than liver idsease. The estimation of hydroxyproline excretion furthermore gives information on the activity of bone metastasis, and its response to treatment, which cannot be given by radiological or scintigraphic methods. It is doubtful whether urinary hydroxyproline estimation will help to detect bone metastases before they are apparent on scintigrams. When the bone scan is doubtful, as often occurs in older subjects, hydroxyproline excretion has been found to be helpful in classifying the patient. When scintigraphy is not available, an elevation of hydroxyproline excretion, together with an elevation of Ca/cr ratio or alkaline phosphatase activity, may pre-date by several months the radiological demonstration of osseous metastases.
Highlights
Urinary hydroxyproline excretion is a reliable method of selecting those patients whose elevated serum alkaline phosphatase is secondary to bone disease rather than liver disease
It is doubtful whether urinary hydroxyproline estimation will help to detect bone metastases before they are apparent on scintigrams
The results of this study of 181 consecutive patients with breast carcinoma confirm those reported by others (Rubegni, Ravenni and Del Giovane, 1962; Platt et at., 1964; Bonadonna et at., 1966; Hosley et al, 1966; Guzzo et al, 1969; Cushieri and Felgate, 1972; Summer et al, 1973), that increased hydroxyproline excretion is a sensitive index of the presence of bone metastases
Summary
Urinary hydroxyproline excretion is a reliable method of selecting those patients whose elevated serum alkaline phosphatase is secondary to bone disease rather than liver disease. The estimation of hydroxyproline excretion gives information on the activity of bone metastasis, and its response to treatment, which cannot be given by radiological or scintigraphic methods. It is doubtful whether urinary hydroxyproline estimation will help to detect bone metastases before they are apparent on scintigrams. THE APPROPRIATE staging of patients with carcinoma of the breast is of primary importance to the rationalization of the choice of subsequent treatment. In 85% of women dying from this particular disease, skeletal lesions were found when a careful autopsy had been carried out (Jaffe, 1958)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have