The value of human epididymis protein 4 (HE4) as a serum tumor marker for accurate bone metastases finding by whole-body bone scintigraphy in lung cancer patients.

The aim of our study was to correlate the serum concentration of human epididymis protein 4 (HE4) in lung cancer patients with the bone metastases detected by whole-body bone scintigraphy. The serum concentrations of HE4 were determined by electrochemiluminescence immunoassay method in 60 patients with lung cancer and in 10 persons without malignant disease (control group). All participants were examined by whole-body bone scintigraphy with hybrid gamma camera of type BrightView XCT. We found bone metastases in 25.0% of patients by whole-body bone scintigraphy and probable bone metastases in 18.3% of patients. We did not observe bone metastases in 56.7% of patients and in nobody from control group. We observed that 73.33% patients with bone metastases had more than 3 bone metastasis deposits. Patients had significantly increased concentration of HE4 (p < 0.0001). All three subgroups of patients (bone metastases, probable bone metastases, no evidence of bone metastases) had significantly increased concentration of HE4 compared to controls. The highest concentration of HE4 had 9 patients with small-cell lung cancer of whose 4 patients had bone metastases, 4 patients had probable bone metastases and one patient was with no evidence of bone metastases. We found that HE4 has a discriminatory ability to differentiate groups of patients and healthy controls, as well as within scaffold scintigraphy in patients with lung cancer (p = 0.0002). The serum concentration of human epididymis protein 4 was significantly increased in patients with lung cancer in comparison with persons of control group. A quarter of lung cancer patients had identified bone metastases by whole-body bone scintigraphy and approximately 20% of patients had probable bone metastases. The increasing serum concentrations of human epididymis protein 4 can have importance in the diagnosis of bone metastases in patients with lung cancer, in particular in small-cell lung cancer.

[The possibility of the serum concentration of osteocalcin determination in lung cancer patients with suspected bone metastases]. / Moznosti stanovenia sérovej koncentrácie osteokalcínu u pacientov s karcinómom plúc pri podozrení na kostné metastázy.

AIM: The aim of this study was to compare serum levels of biochemical markers of bone metabolism - osteocalcin (OC) in correlation with bone metastases found during whole-body bone scintigraphy in patients with lung cancer. MATERIAL AND METHODS: The serum levels of OC as a bone formation marker were determined in 60 patients (46 male, 14 female, mean age 66.65, range 50-84 years) with lung cancer (51 non-small-cell lung cancers - NSCLC and nine small-cell lung cancers - SCLC) and correlated with the presence of bone metastases detected by whole-body bone scintigraphy (hybrid system SPECT/CT: BrightView XCT, Philips Healthcare). Whole-body bone scintigraphy results were compared with OC for each patient with lung cancer and for person from control group of 10 persons (two males, eight females, mean age 52.3, range 34-67 years) with-out malignant disease. RESULTS: By whole-body bone scintigraphy, bone metastases were found in 15 cases (25%), probably in 11 cases (18.33%) and 34 patients (56.67%) were without bone metastases out of 60 patients with lung cancer. The serum levels of OC were above reference range in five cases (8.33%) only with NSCLC and below reference range in 12 cases (20%) - in 10 cases in patients with NSCLC and in two cases in patients with SCLC. In control group of 10 persons, serum level of OC was below reference range only in one case. CONCLUSION: The serum concentrations of osteocalcin were not correlated with findings performed bywhole-body bone scintigraphy in patients with lung cancer. Osteocalcin serum levels determination probably does not have diagnostic importance in lung cancer patients with suspected bone metastases.