碱性磷酸酶骨同工酶的测定及其与骨肉瘤的相关性研究

对骨肉瘤的诊断、化疗效果的评价、预后的判断以及对骨肉瘤复发和转移的量化性监测的价值。方法：采用单克隆抗体免疫捕获法检测42例原发性骨肉瘤患者在治疗前后及随访期间血清中BALP，全自动生化仪检测血清总碱性磷酸酶（alkaline phosphatase，ALP），取治疗前活检组织及手术中肿瘤组织标本，计数肿瘤细胞坏死率，并对检测结果进行比较、分析。结果：本组42例患者随访5～49个月，平均24.3个月，随访期间18例出现复发转移，16例死亡，其余患者均为无瘤生存。BALP比ALP在骨肉瘤的诊断上具有更高的灵敏性（P=0.015）；手术后ALP和BALP均降低至正常范围。化疗后BALP的降低比值与肿瘤细胞坏死率的升高呈正相关(P=0.001 r=0.642)。随访期间肿瘤复发转移组与无瘤生存组ALP差异无统计学意义（P=0.061），但在BALP水平上差异有统计学意义（P=0.000）。结论：BALP作为骨肉瘤血清学检查的一个指标，具有比ALP更高的灵敏度，在骨肉瘤的诊断、治疗效果的监测和预后的判断上具有很高的应用价值。

Bone alkaline phosphatase measurement and its relation with osteosarcoma

Objective: To explore the value of bone alkaline phosphatase(BALP) on diagnosing osteosarcoma,evaluating the effect of chemotherapy,judging the prognosis and supervising the relapse and metastasis.Methods: The immunoassay was used to check the serum BALP in 42 patients with primary osteosarcoma,and auto biochemistry equipment to determine the serum Alkaline Phosphatase(ALP).The biopsy tissue and the lesion moved in the operation were treated with pathology,and their histological responses were counted.Results: During a follow-up from 5 months to 49 months with an average of 24.3 months,18 patients had relapsed or transferred osteosarcoma,16 died,others were surviving to the end of follow-up.BALP was more sensitive than ALP in diagnosing osteosarcoma(P=0.015).Both ALP and BALP decreased to normal value in postoperative in all.The decrease of BALP was positively correlated with the increase of histological response(P=0.001,r=0.642),and the BALP in the group of relapse and transfer was significantly different from that in the group of free disease survival(P=0.000).Conclusion: As a check mark in blood serum,BALP is more sensitive to the process of ossification than ALP,and therefore it is valuable in the diagnosis of osteosarcoma,reflection of the effect of chemotherapy and forecast of the prognosis.