The clinical importance of bone metabolic markers in detecting bone metastasis of lung cancer

• Published in: International journal of clinical oncology Vol. 17; no. 2; pp. 112 - 118
• Main Authors: Bayrak, Suna Bilgin, Ceylan, Emel, Serter, Mukadder, Karadağ, Fisun, Demir, Ece, Çildağ, Orhan
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01-04-2012; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Alkaline phosphatase; Alkaline Phosphatase - blood; Biomarkers; Biomarkers, Tumor - blood; Bone cancer; Bone loss; Bone Neoplasms - blood; Bone Neoplasms - diagnosis; Bone Neoplasms - secondary; Bones; Cancer Research; Clinical trials; Collagen Type I - blood; Computed tomography; Humans; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - pathology; Male; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Multimodal Imaging; Non-small cell lung carcinoma; Oncology; Original Article; Osteocalcin; Osteocalcin - blood; Osteogenesis; Peptides - blood; Positron emission tomography; ROC Curve; Scintigraphy; Serum levels; Surgical Oncology; Tomography, X-Ray Computed; Bone metabolic markers; Bone metastasis; Lung cancer
• DOI: 10.1007/s10147-011-0266-7
• EISSN: 1437-7772
• ISSN: 1341-9625

Aim
The aim of this study was to evaluate the role of bone metabolic markers in clinical evaluation of bone metastasis of lung cancer.
Materials and methods
Sixty-five male patients with lung cancer were included in this trial, 77% of whom were diagnosed as having non-small cell lung cancer and 20% were small cell lung cancer. The presence of bone metastasis was investigated by whole-body bone scintigraphy via Tc-99m mostly (80%) and, in some cases, PET/CT (positron emission tomography and computerized tomography) which was performed for staging. Bone-specific alkaline phosphatase (BALP) and osteocalcin were measured in serum of the patients as markers of bone formation. N-terminal telopeptide (NTX) and β-form of C terminal telopeptide (β-CTX) were studied as bone destruction markers.
Results
The cases were divided into two groups according to the presence of bone metastasis. Twenty-three patients (35%) had bone metastasis. Serum levels of total ALP, BALP and NTX were significantly higher in the group with bone metastasis (
p
 < 0.05). Osteocalcin and β-CTX levels were not significantly different between two groups. According to ROC-curve analysis, at the threshold value of 22.38 μg/L, the sensitivity of BALP was 60.87% and the specificity was 69.05%. Similarly, at the threshold value of 25.69 nmol BCE, the sensitivity of NTX was 90.24% and the specificity was 43.4%.
Conclusion
Bone metabolic markers are considered noninvasive, useful and cost-effective. However, more prospective studies are needed in order to use them for evaluation of bone metastasis in lung cancer.