血清破骨细胞分化因子及生成抑制因子测定在前列腺癌骨转移诊断中的价值
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摘要
目的探讨检测破骨细胞分化因子(osteoclast differentiation factor,ODF)和破骨细胞生成抑制因子(osteo-clastogenesis inhibitory factor,OCIF)对前列腺癌骨转移诊断及病情评价的临床价值。方法分析2010年1月~2011年12月114例初诊为前列癌患者的资料。前列腺癌骨转移组和非骨转移组分别为61例和53例,采用ELISA法测定各组血清ODF和OCIF浓度。结果骨转移组患者血清ODF和OCIF分别为(31.35±5.34)和(42.12±9.04)ng/L,明显高于非骨转移组的(8.42±1.73)和(9.84±2.15)ng/L,差异有显著性(P<0.01)。ODF和OCIF诊断前列腺癌骨转移ROC曲线下面积分别为0.92和0.88,具有良好的诊断价值。诊断前列腺癌骨转移的灵敏度、特异度,ODF分别为91.42%和87.35%;OCIF分别为87.51%和85.37%。ODF随骨转移部位数量增加而明显升高,OCIF随骨转移部位数量增加而明显降低。新发骨转移组和骨转移组血清ODF和OCIF浓度均显著高于非转移组,差异有显著性(P<0.01);新发骨转移组血清ODF和OCIF浓度与骨转移组比较,两组间无显著性差异(P>0.05)。结论前列腺癌患者发生骨转移时,血清ODF和OCIF含量明显增高,可作为判断前列腺癌患者骨转移及监测病情的参考指标,在临床上有广泛的应用前景。
【Objective】This study was aimed to investigate the value of osteoclast differentiation factor(ODF) and osteoclastogenesis inhibitory factor(OCIF) detection for clinical diagnosis and assessment of patient condition in bone metastasis of prostate cancer. 【Methods】Data from 114 lung cancer patients who were preliminary diagnosed between January 2010 and December 2011 were analyzed. The cases were divided into the bone metastasis group with 61 cases(group A) and the non-bone metastasis group with 53 cases(group B). Concentrations of serum ODF and OCIF in each group were detected by ELISA.【Results】ODF and OCIF values of group A were(31.35±5.34) ng/L and(42.12±9.04)ng/L, respectively, which were significantly higher than the corresponding values in group B [(8.42 ± 1.73)ng/L and(9.84±2.15)ng/L]. The differences between the two groups were statistically significant(P <0.01). Areas under the receiver operating characteristic curves of ODF and OCIF, which are used to diagnose bone metastasis in lung cancer, were 0.92 and 0.88, respectively, manifesting good diagnostic value. The sensitivity and specificity of ODF in diagnosing prostate cancer with bone metastasis were 91.42% and 87.35%, respectively, and those of OCIF were 87.51% and 85.37%, respectively. ODF increased, whereas OCIF decreased significantly, with increasing bone metastasis. ODF and OCIF concentrations in group A and the group with newly-found bone metastasis were significantly higher than those in group B, with statistically significant differences among these groups(P <0.01). Compared with group A, less difference was found in the ODF and OCIF of newly-found bone metastases, without statistical significance between these groups(P >0.05). 【Conclusion】The serum ODF and OCIF concentrations significantly increase when bone metastasis occurs in prostate cancer patients. Hence, these variables are useful as indices for monitoring bone metastases and evaluating patient condition. An extensive application prospect is proposed.
【Objective】This study was aimed to investigate the value of osteoclast differentiation factor(ODF) and osteoclastogenesis inhibitory factor(OCIF) detection for clinical diagnosis and assessment of patient condition in bone metastasis of prostate cancer. 【Methods】Data from 114 lung cancer patients who were preliminary diagnosed between January 2010 and December 2011 were analyzed. The cases were divided into the bone metastasis group with 61 cases(group A) and the non-bone metastasis group with 53 cases(group B). Concentrations of serum ODF and OCIF in each group were detected by ELISA.【Results】ODF and OCIF values of group A were(31.35±5.34) ng/L and(42.12±9.04)ng/L, respectively, which were significantly higher than the corresponding values in group B [(8.42 ± 1.73)ng/L and(9.84±2.15)ng/L]. The differences between the two groups were statistically significant(P <0.01). Areas under the receiver operating characteristic curves of ODF and OCIF, which are used to diagnose bone metastasis in lung cancer, were 0.92 and 0.88, respectively, manifesting good diagnostic value. The sensitivity and specificity of ODF in diagnosing prostate cancer with bone metastasis were 91.42% and 87.35%, respectively, and those of OCIF were 87.51% and 85.37%, respectively. ODF increased, whereas OCIF decreased significantly, with increasing bone metastasis. ODF and OCIF concentrations in group A and the group with newly-found bone metastasis were significantly higher than those in group B, with statistically significant differences among these groups(P <0.01). Compared with group A, less difference was found in the ODF and OCIF of newly-found bone metastases, without statistical significance between these groups(P >0.05). 【Conclusion】The serum ODF and OCIF concentrations significantly increase when bone metastasis occurs in prostate cancer patients. Hence, these variables are useful as indices for monitoring bone metastases and evaluating patient condition. An extensive application prospect is proposed.
引文
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[2]LECOUVET FE,SIMON M,TOMBAL B,et al.Whole-body MRI(WB-MRI)versus axial skeleton MRI(AS-MRI)to detect and measure bone metastases in prostate cancer(PCa)[J].European Radiology,2010,20(12):2973-2982.
[3]DE BONO JS,LOGOTHETIS CJ,MOLINA A,et al.Abiraterone and increased survival in metastatic prostate cancer[J].New England Journal of Medicine,2011,364(21):1995-2005.
[4]NΦRGAARD M,JENSEN AΦ,JACOBSEN JB,et al.Skeletal related events,bone metastasis and survival of prostate cancer:a population based cohort study in Denmark(1999 to 2007)[J].The Journal of Urology,2010,184(1):162-167.
[5]LEIBBRANDT A,PENNINGER JM.RANKL/RANK as key factors for osteoclast development and bone loss in arthropathies[M]//Molecular Mechanisms of Spondyloarthropathies.Springer New York,2009:100-113.
[6]LEIBBRANDT A,PENNINGER JM.RANKL/RANK as key factors for osteoclast development and bone loss in arthropathies[M]//Molecular Mechanisms of Spondyloarthropathies.Springer New York,2009:100-113.
[7]TA HM,NGUYEN GTT,JIN HM,et al.Structure-based development of a receptor activator of nuclear factor-κB ligand(RANKL)inhibitor peptide and molecular basis for osteopetrosis[J].Proceedings of the National Academy of Sciences,2010,107(47):20281-20286.
[8]YASUI T,KADONO Y,NAKAMURA M,et al.Regulation of RANKL-induced osteoclastogenesis by TGF-βthrough molecular interaction between Smad3 and Traf6[J].Journal of Bone and Mineral Research,2011,26(7):1447-1456.
[9]赵雪志,李纲,王振杰,等.前列腺癌,前列腺增生症患者血清骨保护素测定的临床价值[J].现代泌尿外科杂志,2011,16(5):443-445.[9]ZHAO XZ,LI G,WANG ZJ,et al.The clinical value of serum concentration of osteoprotegerin in prostatic carcinoma and hyperplasia[J].Journal of Modern Urology,2011,16(5):443-445.Chinese
[10]DINTER DJ,NEFF WK,KLAUS J,et al.Comparison of whole-body MR imaging and conventional X-ray examination in patients with multiple myeloma and implications for therapy[J].Annals of Hematology,2009,88(5):457-464.
[11]FELLNER M,BAUM RP,KUB??EK V,et al.PET/CT imaging of osteoblastic bone metastases with 68 Ga-bisphosphonates:first human study[J].European Journal of Nuclear Medicine and Molecular Imaging,2010,37(4):834-834.