血浆钙调节激素和骨生化标志物与癌症骨转移的关系研究

Study of the relationship between plasma calcium regulating hormones and bone biochemical markers and cancer bone metastases

目的观察癌症骨转移患者血浆钙调节激素的含量变化与骨转移发生、发展的关系。方法用免疫化学发光法和生化分光光度法测定癌症骨转移患者46例、非骨转移患者31例、正常健康人38例血浆甲状旁腺素(PTH)、降钙素(CT)、骨钙素(BGP)和血钙(Ca)、血磷(P)、血碱性磷酸酶(ALP)水平。结果肿瘤非骨转移患者组与对照组比较:血浆总Ca、P、ALP、PTH和BGP无差异,CT与对照组比较显著性增高(P<0.01);肿瘤骨转移患者与对照组比较:血浆总Ca、ALP、PTH、CT和BGP显著性增高(P<0.01),血P显著性降低(P<0.01);肿瘤骨转移患者与非骨转移患者组比较血浆总Ca、ALP、PTH、CT和BGP均显著性增高(P<0.01);血P显著性降低(P<0.01)。骨转移组随着转移病灶数量的增加,血Ca、ALP、CT、BGP和PTH的含量有上升趋势。结论血浆钙调节激素和骨生化标志物对癌症的骨转移诊断具有一定临床价值。

Objective To observe the relationship between the changes of plasma calcium regulating hormone and the occurrence and progress of bone metastases of cancer. Methods The plasma concentrations of parathyroid hormone （PTH） , calcitonin （CT）, bone Gla protein （BGP） , calcium （Ca）, phosphorus （P）, and alkaline phosphatase （ALP） of 46 cancer patients with bone metastases, 31 cancer patients without bone metastases, and 38 normal healthy people were measured using chemiluminescence immunoassay and biochemistry spectrophotometry. Results The comparison between cancer patients without bone metastases group and control group showed that there was no significant difference in terms of plasma concentrations of total Ca, P, ALP, PTH, and BGP. CT concentration in cancer patients without bone metastases was significantly higher than that in control group （P 〈 0. 01 ）. The comparison between cancer patients with bone metastases group and control group showed that plasma concentrations of total Ca, ALP, PTH, CT, and BGP in cancer patients with bone metastases were significantly higher （P 〈 0. 01 ） , and the concentration of P was significantly lower （ P 〈 0. 01 ） , than those in control group. The comparison between cancer patients with bone metastases group and cancer patients without bone metastases group showed that plasma concentrations of total Ca, ALP, PTH, CT, and BGP of cancer patients with bone metastases were significantly higher （P 〈 0.01 ） , and the concentration of P was significantly lower （P 〈 0.01 ） , than those in cancer patients without bone metastases. The serum concentrations of Ca, ALP, CT, BGP, and PTH had up trend elong with the increased number of metastatic bone lesions. Conclusion Plasma calcium regulating hormones and bone chemistry markers have significant clinical values to the diagnosis of bone metastases.