血清ICTP与TRACP 5b联合检测在乳腺癌骨转移诊断中的价值

目的:探讨溶骨性骨代谢标志物血Ⅰ型胶原交联羧基末端肽(ICTP)和血抗酒石酸酸性磷酸酶5b(TRACP 5b)的检测对诊断乳腺癌骨转移的价值.方法:用ELISA法测定78例乳腺癌患者及40例乳腺良性肿瘤患者血清ICTP和TRACP 5b水平,比较两者水平在骨转移、非骨转移乳腺癌患者及良性乳腺肿瘤患者中的差异及其相关性.结果:乳腺癌骨转移患者血清ICTP和TRACP 5b水平均明显高于无骨转移及乳腺良性肿瘤患者(均P＜0.001),而后两者间无统计学差异(均P＞0.05).乳腺癌患者血清ICTP与TRACP 5b浓度表达呈正相关(r=0.63,P＜0.01).血清ICTP和TRACP诊断乳腺癌骨转移的敏感性、特异性和准确性分别为55.3％,92.5％,81.4％和84.2％,83.8％,83.9％,两者联合检测分别为94.7％,81.3％,85.6％.结论:血清ICTP和TRACP 5b对乳腺癌骨转移的诊断均有重要价值,两者联合检测有助于提高诊断的敏感性和准确性.

Combined detection of serum ICTP and TRACP 5b for diagnosis of breast cancer bone metastasis

Objective: To evaluate the value of the combined detection of serum levels of bone turnover markers ICTP (pyridinoline crosslinked C-telopeptides of type I collagen) and TRACP 5b (tartrate-resistand acid phosphatase 5b) for diagnosis of breast cancer bone metastasis. Methods: The serum levels of ICTP and TRACP 5b in 78 patients with breast cancer and 40 patients with benign breast tumors were measured by ELISA assay. The differences in serum levels of the two markers among breast cancer patients with bone metastases, breast cancer patients without bone metastasis and benign breast tumor patients were compared, and the correlation between both levels was also analyzed. Results: The serum levels of both ICTP and TRACP 5b in breast cancer patients with bone metastases were significantly higher than those in breast cancer patients without bone metastasis and benign breast tumor patients (all P<0.001), while both levels between the latter two showed no significant differences (both P>0.05). There was a positive correlation between serum ICTP and TRACP 5b levels in breast cancer patients (r=0.63, P<0.01). For diagnosis of breast cancer bone metastasis, the sensitivity, specificity and accuracy of serum ICTP detection were 55.3%, 92.5% and 81.4%, those of serum TRACP 5b detection were 84.2%, 83.8%, 83.9%, and the combined detection rates were 94.7%, 81.3% and 85.6%, respectively. Conclusion: Both serum ICTP and TRACP 5b levels have important value for diagnosis of breast cancer bone metastasis, and their combined detection can improve the diagnostic sensitivity and accuracy.