血清ICTP、ALP测定对骨肿瘤的诊断价值

Application of cross-linked telopeptide of type I collagen, alkaline phosphatase in bone tumor

目的 检测原发性良性骨肿瘤、原发性恶性骨肿瘤及转移性骨肿瘤患者血清中的Ⅰ型胶原交联羧基端肽（ICTP）和碱性磷酸酶（ALP）活性,以观察ICTP和ALP在骨肿瘤的鉴别诊断中的价值.方法 将2012年中南大学湘雅医院收治的16例原发性良性骨肿瘤、16例原发性恶性骨肿瘤及18例转移性骨肿瘤患者作为研究对象,并将同期的16例没有骨骼、关节、肝脏及肠道等疾病的正常人群作为正常对照组.采用法国临床化学会推荐的速率法测定血清ALP活性及酶免疫测定法（EIA）测定ICTP水平.结果 除原发性良性骨肿瘤与正常对照组血清ICTP差异无统计学意义（P＞0.05）外,其余各组两两之间差异均有统计学意义（P＜0.05）；除原发性恶性骨肿瘤组血清ALP显著高于其余各组,且差异有统计学意义（P＜0.01）外,其余各组两两比较差异均无统计学意义（P＞0.05）.ICTP诊断原发性良性骨肿瘤、转移性骨肿瘤、原发性恶性骨肿瘤的AUC值（0.923、0.926、0.874）高于ALP的ROC曲线下面积（AUC）值（0.354、0.702、0.865）.结论 血清ICTP和ALP是反映骨肿瘤骨代谢的一个灵敏而简便的生化指标,其血清ICTP比ALP更为特异和敏感,对骨肿瘤的鉴别诊断具有一定的临床意义,可作为骨肿瘤诊断的指标之一.

Objective To determine the serum levels of cross-linked telopoptide of type Ⅰ collagen （ICTP）,alkaline phosphatase （ALP） in patients with primary malignant bone tumor,primary benign bone tumor and malignant tumor metastasized to the bone,and to explore the clinical value of ICTP and ALP in identification and diagnosis of bone tumor.Methods Sixteen primary malignant bone tumor patients,16 primary benign bone tumor patients and 18 malignant tumor metastasized to the bone patients in 2012 were studied.Serum ALP was assayed by SFBC rate method and ICTP by enzyme linked immunosorbent assay （EIA）.Results The serum levels of ICTP was not significantly different between primary benign bone tumors and normal control group （P 〉 0.05）,but the other between-groups had statistically significant difference （P 〈 0.05）.The serum levels of ALP in malignant tumor metastasized to the bone was significantly higher than the rest of the group （P 〈0.01）,but the difference between the remaining groups was not statistically significant （P 〉 0.05）.The area under roc curve （AUC） of ICTP for diagnosis of primary benign bone tumors,malignant tumor metastasized to the bone,primary malignant bone tumor （0.923,0.926,0.874） was higher than the ALP （0.354,0.702,0.865）.Conclusions Serum ICTP and ALP were sensitive and convenient biochemical indices which reflected metabolism of patients with bone tumor.Serum ICTP was more specific and sensitive than ALP and they have clinical importance for differential diagnosis as an index of bone tumor.