血清骨转换标志物在卵巢癌骨转移诊断中的应用

Clinical application value of bone turnover markers in ovarian cancer patients with bone metastases

目的血清骨转换标志物主要有β-Ⅰ型胶原羧基端肽(β-C-terminal telopeptide of typeⅠcollagen,β-CTx)、总I型胶原氨基端延长肽(procollagen typeⅠN-terminal propeptide,P1NP)和N-端骨钙素(N-MID Osteocalcin,N-MID)。恶性肿瘤发生骨转移时导致骨质破坏,可引起血清骨转换标志物水平的改变。本研究旨在探讨血清骨转换标志物水平在卵巢癌骨转移中的临床应用价值。方法选择2013-03-01-2017-02-28武汉市第五医院就诊的76例卵巢癌病例和40名健康体检者为研究对象,将研究对象分为骨转移组(36例)、非骨转移组(40例)和健康对照组(40名)。采用电化学发光法检测其血清β-CTx、P1NP和N-MID的表达水平。结果卵巢癌骨转移组血清β-CTx和P1NP水平分别为(0.79±0.03)和(195.27±109.61)ng/mL,非骨转移组血清β-CTx和P1NP水平分别为(0.46±0.18)和(76.59±26.37)ng/mL,差异有统计学意义,P<0.01;骨转移组和非骨转移组血清N-MID水平分别为(19.04±8.88)和(17.63±7.69)ng/mL,差异无统计学意义,P>0.05。β-CTx诊断卵巢癌骨转移的灵敏度、特异度和准确度分别为69.4%、87.5%和78.9%;P1NP诊断卵巢癌骨转移的灵敏度、特异度和准确度分别为77.8%、100.0%和89.5%;两者联合诊断的灵敏度、特异度和准确度分别为94.4%、87.5%和90.8%。骨转移组血清β-CTx和PINP水平间无相关性,P>0.05。结论血清β-CTx和P1NP对卵巢癌骨转移具有较高的辅助诊断价值,在骨转移诊断及病情监测中有重要意义。

OBJECTIVE When tumor cells metastasize to bone, it disrupts normal bone remodeling processes and cause to change the level of serum bone turnover markers includingl-C-terminal telopeptide of type I collagen, procollagen type I N-terminal propeptide and N-MID. Osteocalcin. The purpose of this study was to assess the clinical application value of bone turnover markers （19-CTx, P1NP, N-MID） in ovarian cancer patients with diagnosing bone metastases. METHODS 76 cases ovarian cancer patients and 40 cases normal control were selected from the Fifth Hospital of Wuhan from Mar 2013 to Feb 2017. β-CTx, P1NP and N-MID were measured in 36 cases with bone metastases from ovarian cancer, 40 cases without bone metastases from ovarian cancer and 40 cases of normal controls. These markers was detec- ted by chemiluminescence. RESULTS The level of β-CTx and P1NP in patients with bone metastasis were （0. 79 ±0.03） ng/mL and （195. 27±109.61） ng/mL respectively. The level of β-CTx and P1NP in patients without bone metas- tasis were （0.46±0.18） ng/mL and （76.59±26.37） ng/mL respectively. The level of 13-CTx and PINP increased signif- icantly in patients with bone metastasis （P%0. 01）. The level of N-MID in patients in two groups were （19. 04±8.88） ng/mL and （17.63 ±7.69） ng/mL respectively. There was no significant difference in the level of N-MID between the patients with bone metastasis and without bone metastasis （P%0. 05）. The sensitivity, specificity and accuracy of%-CTx in the diagnosis of bone metastases from ovarian cancer were 69.4%, 87.5% and 78.9% respectively. The sensi- tivity, specificity and accuracy of P1NP in the diagnosis of bone metastases from ovarian cancer were 77.8 ±0,100.0 ±0 and 89.5%. Combination of the two, the sensitivity, specificity and accuracy in the diagnosis of bone metastases were 94. 4%, 87.5% and 90.8% respectively. There were no significant correlations among the level of β-CTx and PINP （P〈 0.05）. CONCLUSION In ovarian cancer patients with bone metastases, β-CTx and P1NP can help to make diagnosis.