Diagnostic value of urinary pyridinoline for determining bone metastasis in patients with non-metastatic breast cancer

Yıl 2011, , 420 - 424, 01.12.2011

Zeynep Giniş Sevilay Sezer Nuriye Özdemir Fatma Uçar Serpil Turhan

https://doi.org/10.5799/ahinjs.01.2011.04.0085

Öz

Objective: In this study, urinary pyridinoline (uPYR), urinary deoxypyridinoline (uDPD) and serum alkaline phosphatase (sALP) levels were measured in patients without metastatic breast cancer and the role of uPYR and uDPD as biochemical markers of bone metastases were examined during a six years follow-up. Materials and methods: Totally, 34 patients without bone metastasis and 40 healthy individuals as a control group were included in the study. Results: Urinary pyridinoline and uDPD levels were significantly higher in patients without bone metastasis than in normal controls (p

Anahtar Kelimeler

Breast neoplasms, bone metastases, deoxypyridinoline, pyridinoline

Diagnostic value of urinary pyridinoline for determining bone metastasis in patients with non-metastatic breast cancer

Öz

Amaç: Bu çalışmada metastazı olmayan meme kanserli hastalarda idrar piridinolin, deoksipiridinolin ve serum alkalen fosfataz düzeyleri ölçüldü ve 6 yıllık takipte kemik metastazının biyokimyasal belirteçleri olarak idrar piridinolin ve deoksipiridinolinin rolü değerlendirildi. Gereç ve yöntem: Çalışma kemik metastazı olmayan 34 hasta ve kontrol grubu olarak 40 sağlıklı bireyi içermektedir. Bulgular: Serum ALP hariç idrar piridinolin ve deoksipiridinolin düzeyleri kemik metastazı olmayan hastalarda kontrol grubundan belirgin olarak yüksekti. 6 yıllık takip sonucunda hastaların %20.5\'da metastaz olduğu belirlendi. Metastaz tiplerinin dağılımı: %2.9 lokal, %2.9 karaciğer, %5.9 akciğer ve %8.8 kemik metastazı. Piridinolin için 43 pmol/ µmol kreatinin cut off değerinin sensitiivtesi %82 ve spesifitesi %80 olarak belirlendi. Deoksipiridinolin için 9.53 pmol/ µmol kreatinin cut off değerinin sensitiivtesi %76 ve spesifitesi %72 olarak belirlendi. Sonuç: Bu çalışma idrar çapraz bağlarının ölçümünün meme kanserinde kemiğe metastatik yayılımın erken belirlenmesine katkıda bulunabileceğini gösterdi. Ancak geniş ölçekli gruplarla ileri çalışmalar yapılmalıdır.

Anahtar Kelimeler

Meme kanserleri, kemik metastazları, deoksipiridinolin, piridinolin.

Kaynakça

• Ferlay J, Bray F, Pisani P, et al. Globocan 2002: Cancer Incidence, Mortality and Prevalence Worldwide,Version 2.0: IARC CancerBase no.5, Lyon, IARCPress, 2004.
• Coleman RE, Rubens RD. The clinical course of bone metastases from breast cancer. Br J Cancer 1987; 55(1):61-6.
• Roodman G.D. Mechanisms of Bone Metastasis. N Engl J Med 2004; 50(12):1655-64.
• Padalecki SS, Guise TA. The role of bisphosphonates in breast cancer: Actions of bisphosphonates in ani- mal models of breast cancer. Breast Cancer Resch 2002;4:35-41.
• Demers LM. Biochemical markers in the management of patients with metastatic bone disease. Clin Chem 2002;45(8): 1131-2.
• Walls J, Assiri A, Howell A, et al. Measurement of uri- nary collagen cross-links indicate response to therapy in patients with breast cancer and bone metastases. Br J Cancer 1999; 80(8):1265-70.
• Fohr B, Dunstan CR, Seibel MJ. Clinical review 165: Markers of bone remodeling in metastatic bone dis- ease. J Clin Endocrinol Metab 2003; 88(11):5059-75
• Pecherstorfer M, Zimmer-Roth I, Schilling T, et al. The diagnostic value of urinary pyridinium cross-links of collagen, serum total alkaline phosphatase, and uri- nary calcium excretion in neoplastic bone disease. J Clin Endocrinol Metab 1995; 80:97–103.
• Hou MF, Lin SB, Yuan SS, et al. Diagnostic value of urine deoxypyridinoline for detecting bone metasta- ses in breast cancer patients. Ann Clin Lab Sci 2003; 33(1):55-61.
• Koizumi M, Ogata E. Bone metabolic markers as gauges of metastasis to bone: a review. Ann Nucl Med 2002; 16(3):161-8.
• Bombardieri E, Martinetti A, Miceli R, et al. Can bone metabolism markers be adopted as an alternative to scintigraphic imaging in monitoring bone metastases from breast cancer? Eur J Nucl Med 1997; 24:1349– 55
• Hiraide H, Okamura S, Hayashi T, Nishida M, Tamaki K, Tamakuma S. The Urinary Excretion of Pyridinium Cross-links as Markers of Bone Metastasis in Breast Cancer. Breast Cancer 1994; 30;1(2):103-8.
• Walne AJ, Jenkins PJ, James IT, et al. Pyridinium crosslinks in the monitoring of patients with bone me- tastases from carcinoma of the breast. Clin Oncol (R Coll Radiol). 1997; 9(1):30-4.
• Uebelhart D, Schlemmer A, Johansen JS, Gineyts E, Christiansen C, Delmas PD. Effect of menopause and hormone replacement therapy on the urinary excre- tion of pyridinium cross-links. J Clin Endocrinol Metab. 1991;72(2):367-73.
• Shimozuma K, Sonoo H, Fukunaga M, et al. Bio- chemical markers of bone turnover in breast cancer patients with bone metastases: a preliminary report. J Clin Oncol. 1999; 29(1):16-22
• Lipton A, Demers LM; Daniloff Y, et al. Increased uri- nary excretion of pyridinium cross-links in cancer pa- tients. Clin Chem 1993;39(4):614-18
• Dane F, Turk HM, Sevinç A, Büyükberber S, Camci C, Tarakcioglu M. Markers of bone turnover in patients with lung cancer. J Natl Med Assoc 2008;100(4):425-8.
• Brown JE, Cook RJ, Major P, et al. Bone turnover markers as predictors of skeletal complications in prostate cancer, lung cancer, and other solid tumors. J National Cancer Institute 2005; 97(1): 59-69.