多项血清骨转换标志物对老年乳腺癌患者骨转移的诊断价值

Diagnostic validity of multi-serum bone turnover markers in aged breast cancer patients with bone metastasis

目的:探讨老年乳腺癌患者血清骨转换标志物包括Ⅰ型原胶原氨基端前肽(PⅠNP),骨特异性碱性磷酸酶(BAP),抗酒石酸酸性磷酸酶(TRACP5b)和Ⅰ型胶原羧基端肽β特殊序列(β-Crosslaps)及其组合对骨转移的诊断价值。方法:2016年8月~2017年6月前瞻性纳入125例老年浸润性乳腺癌患者,包括骨扫描阳性患者37例,可疑阳性患者27例,阴性患者61例,同时检测血清BAP、TRAP5b、PⅠNP和β-Crosslaps水平,并对结果进行分析。结果:与骨转移可疑组、阴性组相比较,骨转移阳性组的骨形成标志物PⅠNP和BAP及骨吸收标志物β-Crosslaps和TRACP5b的水平明显增高,差异具有统计学意义(P<0.01)。而阴性组和可疑阳性组间的任何一种骨转换标志物水平均无显著性差异(P>0.05)。结论:联合多项血清骨转换标志物可提高诊断老年乳腺癌骨转移的敏感度,尤其在骨扫描假阳性时对骨转移提供更有力的诊断依据。

Objective：To investigate the diagnostic value of bone turnover markers procollagen type Ⅰaminoterminal propeptide（PⅠNP）,bone alkaline phosphatase（BAP）,tartrate-resistant acid phosphatase 5b（TRACP5b）and β isomer of C-terminal telopeptide of typeⅠ collagen（β-Crosslaps）,in aged breast cancer patients with bone metastasis.Methods：As a prospective control study,125 aged breast cancer patients were enrolled including 37 bone metastatic positive patients,27 suspicious positive patients and 61 negative patients which were detected by bone scanning.The following parameters were measured：serum concentrations of BAP,TRAP5 b,PINP and β-Crosslaps.Results：The levels of serum bone metabolic markers of bone metastasis positive group were significantly higher than those of suspicious positive group and negative group（P〈0.01）.And there were no statistically significant differences between suspicious positive group and negative group（P〉 0.05）.Conclusion：It can be effective for diagnosing aged breast cancer with bone metastasis combining multiple serum bone turnover markers.It helps to provide the diagnostic evidence when bone scanning is suspiciously positive in diagnosing bone metastasis.