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目的:探讨溶骨性骨代谢标志物血I型胶原交联羧基末端肽(ICTP)和血抗酒石酸酸性磷酸酶5b(TRACP 5b)的检测对诊断乳腺癌骨转移的价值。方法:用ELISA法测定78例乳腺癌患者及40例乳腺良性肿瘤患者血清ICTP和TRACP 5b水平,比较两者水平在骨转移、非骨转移乳腺癌患者及良性乳腺肿瘤患者中的差异及其相关性。结果:乳腺癌骨转移患者血清ICTP和TRACP 5b水平均明显高于无骨转移及乳腺良性肿瘤患者(均P<0.001),而后两者间无统计学差异(均P>0.05)。乳腺癌患者血清ICTP与TRACP 5b浓度表达呈正相关(r=0.63,P<0.01)。血清ICTP和TRACP诊断乳腺癌骨转移的敏感性、特异性和准确性分别为55.3%,92.5%,81.4%和84.2%,83.8%,83.9%,两者联合检测分别为94.7%,81.3%,85.6%。结论:血清ICTP和TRACP 5b对乳腺癌骨转移的诊断均有重要价值,两者联合检测有助于提高诊断的敏感性和准确性。
OBJECTIVE: To investigate the value of detection of osteolytic bone markers of blood type I collagen cross-linked carboxyl terminal peptide (ICTP) and blood tartrate-resistant acid phosphatase 5b (TRACP 5b) in the diagnosis of bone metastasis of breast cancer. Methods: The serum levels of ICTP and TRACP 5b in 78 cases of breast cancer and 40 cases of benign breast tumor were measured by ELISA. The differences between the two levels in patients with bone metastasis, non-bone metastasis and benign breast cancer were analyzed. Sex. Results: The serum levels of ICTP and TRACP 5b in breast cancer patients with bone metastasis were significantly higher than those without bone metastases and benign breast tumors (all P <0.001). There was no significant difference between the two groups (all P> 0.05). Serum ICTP and TRACP 5b concentrations in breast cancer patients were positively correlated (r = 0.63, P <0.01). The sensitivity, specificity and accuracy of serum ICTP and TRACP in the diagnosis of bone metastasis of breast cancer were 55.3%, 92.5%, 81.4% and 84.2%, 83.8% and 83.9% respectively. The combined detection of serum ICTP and TRACP was 94.7% and 81.3% 85.6%. Conclusion: Both serum ICTP and TRACP 5b have important value in the diagnosis of bone metastasis of breast cancer. The combined detection of serum ICTP and TRACP 5b can improve the diagnostic sensitivity and accuracy.