骨代谢生化指标和恶性肿瘤骨转移不同临床表现的关系

The Relation between Biochemical Markers of Bone Metabolism and Different Clinical Manifestation of Neoplastic Bone Disease

目的探讨骨代谢生化指标尿吡啶酚(uPYD)、尿脱氧吡啶酚(uDPD)、血清骨特异性碱性磷酸酶(sBAP)、血清骨钙蛋白(sBGP)和恶性肿瘤骨转移临床表现的关系。方法采用ELISA方法对99例进展期骨转移阳性肿瘤进行uPYD、uDPD、sBAP、sBGP的浓度水平检测。结果uPYD和uDPD、sBAP和sALP之间显著相关,肿瘤骨转移重度疼痛、无痛和轻度疼痛之间uPYD、uDPD、sALP水平有显著性差异(P<0.05),uDPD、sBAP和sALP水平在不同的骨转移程度有显著性差异(P<0.05),sBAP和sALP水平在不同的骨转移数目有显著性差异(P<0.05)。结论骨转移时uPYD和uDPD、sBAP和sALP之间显著相关,uPYD、uDPD、sBAP水平和骨痛明显相关,uDPD、sBAP水平和肿瘤骨转移程度、骨转移数目明显相关。骨代谢生化指标uPYD、uDPD、sBAP和骨转移临床表现的关系对肿瘤骨转移的病情判断有一定临床意义。

Objective The purpose of this study was to evaluate the clinical significance of biochemical markers of bone metabolism in Neoplastic Bone Disease. These biochemical makers included urinary pyridinoline （uPYD）, urinary deoxypyridinoline （uDPD）, serum bone specific alkaline phosphates （sBAP） and serum bone gamma-corboxy-glutamic acid protein （sBGP）. Methods uPYD, uDPD, sBAP and sBGP were measured by ELISA assay in 99 advanced cancer patients with bone metastasis. Results Significant correlation was observed between uPYD and uDPD, sBAP and sALP in advanced cancer patients with bone metastases. The patients with severe pain had significantly higher levels of uPYD, uDPD and sALP than those patients with no pain and gentle pain. The levels of uDPD, sBAP and sALP were significantly correlated with the disease extent of bone metastasis. SBAP and sALP were significantly correlated with the number of metastatic loci in bone. Conclusion Significant correlation was observed between uPYD and uDPD, sBAP and sALP in advanced cancer patients with bone metastases. The levels of uPYD, uDPD,and sALP were significant correlated with the severity of the bone pain. The levels of uDPD, sBAP showed a direct correlation with the disease extent and the number of metastatic loci in bone.