Significance of prostate specific antigen and markers of bone formation or resorption in diagnosis of bone metastasis of prostate cancer / 中华老年医学杂志

ABSTRACT

Objective To evaluate the significances of prostate specific antigen(PSA),alkaline phosphatase(ALP) as a marker of bone formation,tartrate-resistant acid phosphatase 5b(TRACP5b) and pyridinoline cross-linked carboxy-terminal telopeptide of type Ⅰ collagen(ICTP) as markers of bone resorption in diagnosis of bone metastasis of prostate cancer. Methods Totally 57 elderly patients aged 61-90 years with prostate cancer were divided into groups with bone metastasis(n=27)and without bone metastasis (n=30) according to radionuclide bone imaging,and into progressive(n=18) and limited metastasis groups(n=39) by EOD score.Serum concentrations of PSA,TRACP5b,ALP and ICTP were measured by electrochemiluminescence,colorimetric assay,enzyme-linked immunosorbent assays(ELISA).Sensitivities and specificities were calculated for each marker and the diagnostic values of markers were evaluated by receiver operating characteristic curve (ROC).Resuits The serum levels of PSA,TRACP5b,ALP and ICTP were significantly higher in group with bone metastasis than in group without metastasis (P＜ 0.05).In the progressive bone metastasis group,Gleason score and the concentrations of PSA,ALP,TRACP5b,ICTP were increased as compared with limited metastasis group (P＜ 0.05). In diagnosis of prostate cancer with bone metastasis,the area under ROC curve(AUC) of PSA,TRACP5b,ALP,ICTP were 0.796,0.657,0.762,0.743,respectively.The diagnostic value PSA,ALP and ICTP were comparable,followed by TRACP5b.Using the cut point values of 10.235 μg/L for PSA,4.25 U/L for TRACP5b,116.0 U/L for ALP and 7.6 U/L for ICTP,the sensitivities were 66.7％,59.3％,37％,59.3％ and the specificities were 90％,76.7％,96.7％,80％,respectively.PSA,ALP,ICTP and Gleason score were independent predictors of bone metastasis of prostate cancer,the total coincidence rate of regression model was 84.2％. Conclusions The diagnostic values of PSA,TRACP5b,ALP,ICTP are comparable,the combined and dynamic observation may facilitate early diagnosis of prostate cancer with bone metastasis.