血清Ⅰ型胶原吡啶交联终肽对肿瘤骨转移的早期诊断效能、疗效观察及预后价值的分析

目的 探讨检测血清Ⅰ型胶原吡啶交联终肽(ICTP)在肿瘤骨转移的早期诊断效能、疗效观察及预后价值.方法 选取336例肿瘤患者,依据核素骨显像(ECT)、MRI、X线等检查结果,结合临床分为骨转移组(180例)和未转移组(156例),并对其中60例骨转移者(治疗组)治疗前后的ICTP比较分析;另选60名健康体检者为健康对照组,应用酶免疫技术(EUSA)测定各组血清ICTP水平.将未转移组中61例血清ICTP高于正常值的患者行正电子发射断层成像或X线计算机断层成像(PET/CT)检查,未发现骨转移者,每半年1次进行ECT随访并同时检测ICTP,为期2年.结果 ①骨转移组血清ICTP[(10.47±7.56)μg/L]显著高于未转移组[(5.12±2.33)μg/L](t=9.503,P=0.000)和健康对照组[(2.76±0.62)μg/L](t=13.691,P=0.000).②未转移组中61例血清ICTP高于正常值者,ICTP为(5.98±1.95)μg/L,经PET/CT检查发现骨转移22例,余39例经2年随访发生骨转移26例,ICTP由(5.92±1.61)μg/L上升至(8.73±3.11)μg/L(t=4.612,P=0.000).③治疗有效者血清ICTP较治疗前下降,从(13.22±4.65)μg/L降至(7.18±3.54)μg/L(t=10.076,P=0.000),且疗效越显著,下降越明显.结论 血清ICTP能用于肿瘤骨转移的早期辅诊、筛查和疗效观察,并可监测骨转移的发生及预后判断.

The value of serum ICTP in the early diagnosis, efficacy and prognosis of tumor bone metastasis

Objective To evaluate the serum pyridinoline cross-linked carboxyteminal telopeptide of type Ⅰ collagen ( ICTP) in the early diagnosis potency,efficacy and prognosis of tumor bone metastasis. Methods According to emission computed tomography(ECT) ,MRI and X-ray results,336 cases of tumor were divided into higher ICTP (5. 98 ± 1. 95μg/L ) than normal values. Twenty-two cases were identified bone metastasis through PET/CT examination. 26 cases were identified bone the effective cases decreased from( 13. 22 ± 4.65)μg/L (before treatment) to (7. 18 ±3. 54)μg/L (after treatment) (t = 10. 076,P = 0. 000). Conclusions Serum ICTP is helpful for the early diagnosis, screening and efficacy evaluation of tumor bone metastasis. It could be used for monitoring the occurrence of tumor bone metastasis and its prognosis.