Serum bone TRAP 5b and ICTP as prognostic markers in bone metastases from primary breast cancer

ABSTRACT

Bone is one of the earliest and most common sites for breast cancer metastasis. One-third of cancer patients will have metastases of their primary tumor to bone. The incidence ofbone metastases from primary breast cancer is approximately 13%. Bone marker measurements are noninvasive, inexpensive, and can be repeated often. Markers are derived from both cortical and trabecular bone and reflect the metabolic activity of the entire skeleton. The aim of this work was to determine serum level of Tartrate Resistant Acid Phosphatase 5b [TRAP 5b], Carboxy terminal telopeptide of type I collagen [ICTP] and CA15.3 pre-and post-operatively in patients with primary breast, cancer to asses their values as prognostic factors for the subsequent metastatic disease. Serum samples were collected from 41 females [31 patients with primary breast cancer and 10 normal healthy volunteers]. three samples were collected from patients before surgery, after 10 and 20 months from surgery. Serum TRAP 5b, ICTP a"dCA15,3 were detected by using EIA techniques. Preoperative serum ICTP concentrations >4.6ug/l [2+2SD]. were highly predictive for bone as site of metastases and higher risk of death by three times than those with preoperative serum ICTP concentrations <4.6 micro g/l While after 10 months from surgery. Bone TRAP 5b activity >5.4U/Lwas significantly correlated with poor prognosis for breast cancer and shorter 'wall survival. Serum ICTP concentrations in bone metastases sub. group, after 10 months from surgery [before reflect any Metastasis], were significantly increased from control group. Serum ICTP. TRAP'5b and CA15-3 levels were elevated in bone metastatic patients after 20 months from surgery [bone mciastases had been already diagnosed]. ICTP and TRAP 5b could be useful markers in predicting bone meiastases and might identify patients who would need uliiesorptive treatment in addition to chemotherapy.