血清骨特异性碱性磷酸酶及Ⅰ型胶原吡啶交联终肽与乳腺癌骨转移的相关性分析

 目的　分析血清骨特异性碱性磷酸酶（BAP）和Ⅰ型胶原吡啶交联终肽（ICTP）水平在乳腺癌骨转移与非骨转移患者中的分布及其与临床特征的相关性。方法　收集乳腺癌患者血清217例，通过影像学将患者分为骨转移组（109例）和非骨转移组（108例）。应用酶联免疫吸附法测定两组血清中的BAP及ICTP水平。结果　乳腺癌骨转移组血清BAP及ICTP水平中位数分别为24.8 μg／L（7.6~213.7 μg／L）和7.0 μg／L（1.4~32.4 μg／L），高于非骨转移组的21.2 μg／L（7.3～68.8 μg／L）和4.1 μg／L（0.0～15.8 μg／L）（P＝0.003和P＝0.000），多发骨转移组的BAP及ICTP水平中位数分别为32.3 μg／L（9.4~213.7 μg／L）和7.6 μg／L（1.4～32.4 μg／L），高于单发骨转移组的18.1 μg／L（7.6～60.0 μg／L）和4.9 μg／L（1.8～10.5 μg／L）（P＝0.001和P＝0.010）。血清BAP检测诊断乳腺癌骨转移的灵敏度为45.0 %（49／109），特异度为83.3 %（90／108）；血清ICTP的灵敏度为46.8 %（51／109），特异度为84.3 %（91／108）；两者联合检测的灵敏度为61.5 %（67／109），特异度为71.3 %（77／108）。结论　检测血清BAP及ICTP诊断乳腺癌骨转移的灵敏度较低，不适合作为诊断指标。两者联合检测可以提高灵敏度，对辅助诊断有一定价值。

Relationships between the levels of serum bone-specific alkaline phosphatase, cross-linked telopeptide of type Ⅰ collage and bone metastasis in patients with breast cancer

Objective To analysis the relationships between bone markers, bone-specific alkaline phosphatase （BAP） and cross-linked telopeptide of type I collage （ICTP）, and bone metastasis of breast cancer. Methods A total of 217 patients＇ serum were collected. The 217 cases were divided into two groups： 109 cases with bone metastasis, 108 cases without bone metastasis. Serum BAP and ICTP was measured by ELISA. The relationships between factors of bone metastasis and serum levels of BAP, ICTP were analyzed. Results The levels of serum BAP and ICTP in bone metastases group were significantly higher than those in non-bone metastasis groupBAP： 24.8 μg / L（7.60±213.70 μg / L） vs 21.2 μg / L（7.3-68.8 μg / L）, ICTP：7.0 μg/L（1.4-32.4 μg/L） vs 4.1 μg/L（0.0-15.8 μg/L） （P=0.003, P=0.000）]. The level of serum BAP and ICTP in patients with multiple bone metastasis was significantly higher than that in patients with single bone metastasisBAP：32.3 μg / L（9.A-213.7 μg/L） vs 18.1 μg/L（7.6-60.0 μg/L）, ICTP：7.6 μg/L（1.4± 32.4 μg/L） vs 4.9 μg/L（l.8±10.5 μg/L）, （P=0.001, P=0,010）]. The sensibility of BAP and ICTP was 45.0 % （49/109）and 46.8 % （51/109）, respectively. The specificity of ICTP and BAP was 83.3 % （90/108） and 84.3 % （91/108）, respectively. Joint detection of BAP and＇ICTP had improved sensibility in the diagnosis of bone metastasis in breast cancer patients. Conclusion Joint detection of serum bone biochemical markers ICTP and BAP have a little values for diagnosing bone metastasis in breast cancer patients .