Artikel
Biochemical markers of bone turnover in patients with localized and metastasized prostate cancer
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Veröffentlicht: | 20. März 2006 |
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Gliederung
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Background: Bone metastases are a common feature in prostate cancer (PCA). In the assessment of bone metastases both bone formation and bone resorption markers have reached diagnostic efficacy. The aim of our study was to evaluate and compare the value of several bone turnover markers in different stages of PCA.
Materials and Methods: The prospective study included 219 men: 129 undergoing radical retropubic prostatectomy (RRP,Ø66 y.), 25 with bone metastases due to PCA (osPCA, Ø 70 y.) and 65 with benign urological disorders served as controls (Ø 67 y.). Prior to any treatment serum concentrations of alkaline phophatase (AP), osteocalcin (OC), ß-Crosslaps (CTX) and tartrate-resistant acid phosphatase type 5b (TRACP5b) were determined.
Results: Men undergoing RRP were divided in lymph node negative disease (≤ pT3, lPCA, n=101,Ø 66 y.) and lymph node positive disease (mPCA, n=28, Ø 65.5 y.) after histological examination. The controls showed the lowest marker levels while osPCA group presented the highest markers with significance for AP (p<0.001), OC (p<0.05) and TRACP5b (p<0.001). The mPCA group had significantly elevated serum levels of TRACP5b (p<0.005) and AP (p<0.05) but not for OC (p=0.78) and CTX (p=0.21). See table [Tab. 1].
Conclusions: Our data demonstrate that both bone resorption and bone formation play a crucial role for detection of bone metastases in PCA. Bone turnover markers during follow up after RRP offer a new diagnostic and strategic tool for the clinician in high risk patients. TRACP5b appears to be the most promising serum marker for monitoring.