The Journal of Urology
Volume 178, Issue 3 , Pages 849-853, September 2007

Serum Bone Turnover Markers (PINP and ICTP) for the Early Detection of Bone Metastases in Patients With Prostate Cancer: A Longitudinal Approach

  • N. Koopmans

      Affiliations

    • Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
    • Corresponding Author InformationCorrespondence: Department of Urology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB, Groningen, the Netherlands (telephone: +31-50-3612380; FAX: +31-50-3619607).
    • ,
  • I.J. de Jong

      Affiliations

    • Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
    • ,
  • A.J. Breeuwsma

      Affiliations

    • Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
    • ,
  • E. van der Veer

      Affiliations

    • Department of Pathology and Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands

Received 29 January 2007 published online 16 July 2007.

Purpose

An increase in bone turnover markers in patients with prostate cancer may predict bone metastases but it can also reflect the effects of androgen deprivation treatment. To assess the diagnostic efficacy of early detection of skeletal metastases we retrospectively performed serial measurements of a bone formation marker (PINP) and a bone resorption marker (ICTP) in serum of patients with prostate cancer.

Materials and Methods

Residual serum samples from 64 patients with prostate cancer treated between 1999 and 2004 were selected from our prostate specific antigen serum archive, and divided into 3 groups of patients with no metastases (N0M0), with lymph node metastases only (N1M0) and with skeletal metastases (M1). In the M1 group the T1 sample was collected near the first positive bone scintigraph.

Results

The N1M0 and M1 groups showed increased PINP levels (ANOVA T0 p = 0.035, T1 p <0.001). The PINP levels in the M1 group increased further (paired t test p = 0.028), while no increase was found in the other groups. There was no significant difference between the number of patients receiving androgen deprivation therapy in the N1M0 and the M1 groups. Increased PINP levels in the M1 group were detectable 8 months before the first positive bone scintigraph. The increase in ICTP in the M1 group differed significantly from the other groups (the Student t test in 45 patients p = 0.029). The increases in PINP and ICTP differentiated between patients with or without skeletal metastases (AUC 0.71, p = 0.002 and AUC 0.64, p = 0.045, respectively).

Conclusions

Followup measurement of serum PINP and ICTP is useful in the early assessment of skeletal metastases in patients with prostate cancer regardless of the confounding role of androgen deprivation treatment. The bone formation marker is the most indicative.

Key Words: prostatic neoplasms, biological markers, neoplasm metastasis, bone and bones

Abbreviations and Acronyms: ADT, androgen deprivation therapy, ICTP, pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen, MMP, metalloproteinase, PCa, prostate carcinoma, PINP, amino-terminal procollagen propeptide of type I collagen, PSA, prostate specific antigen

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 30.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 Nothing to disclose.Study received hospital ethical board approval.For another article on a related topic see page 1086.Editor’s Note: This article is the second of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 1128 and 1129.

PII: S0022-5347(07)01238-4

doi:10.1016/j.juro.2007.05.029

Refers to article:

  • Endogenous Bone Morphogenetic Protein-7 Controls the Motility of Prostate Cancer Cells Through Regulation of Bone Morphogenetic Protein Antagonists , 18 July 2007

    Lin Ye, Jonathan M. Lewis-Russell, Howard Kynaston, Wen G. Jiang
    The Journal of Urology September 2007 (Vol. 178, Issue 3, Pages 1086-1091)

The Journal of Urology
Volume 178, Issue 3 , Pages 849-853, September 2007

Article Tools

* Image Usage & Resolution