Efficacy of simultaneous determination of bone alkaline phosphatase mass concentration in serum and urinary excretion of pyridinium cross-links for detection of bone metastases
✍ Scribed by Wolfgang Withold; Georghe Georgescu; Hassan Khakzad; Henning Vosberg; Hans Wilhelm Mueller-Gaertner; Hans Reinauer
- Publisher
- Elsevier Science
- Year
- 1995
- Tongue
- English
- Weight
- 675 KB
- Volume
- 28
- Category
- Article
- ISSN
- 0009-9120
No coin nor oath required. For personal study only.
✦ Synopsis
Objectives: To examine the diagnostic validity of bone alkaline phosphatase (BAP) in serum (a marker of bone formation) and of urinary excretion of pyridinium cross-links (PYR) (a marker of bone resorption) for detection of bone metastases.
Design and Methods: Two heterogeneous immunoassays were employed for determination of BAP mass concentrations (Tan-dem®-R Ostase T') in serum and the urinary excretion of PYR (Collagen Crosslinks T') in a consecutive series of 89 tumor patients examined by bone scintigraphy (with 99rnTc°methylene diphosphonate).
Results:
The discrimination power (as determined by Z score analysis) and the accuracy (as assessed by the area under the receiver-operating characteristic curve) was higher for BAP (0,84) than for PYR (0,76), Combination of both markers yielded a further increase of accuracy (0,89), There was a correlation (r = +0.422; p < 0.001) between the urinary excretion of pyridinium cross-links and bone alkaline phosphatase mass concentrations in the whole of 89 patients examined. In 14 (16%) of 89 patients bone alkaline phosphatase values were within the reference interval in spite of total alkaline phosphatase activity being increased; this indicates a higher diagnostic specificity of bone alkaline phosphatase (compared with total alkaline phosphatase) with respect to detection of bone metastases, Conclusion: Simultaneous assessment of bone formation by BAP and of bone resorption by PYR provides a suitable tool for detection of bone metastases.