Abstract
Setting: We investigated the usefulness of bone markers, respectively Procollagen Type I Aminoterminal Propeptide (PINP) and Beta-Crosslaps (β-CTx) for diagnosis, treatment and monitoring of charges with histologically confirmed breast neoplasm. The intention of this project was the demonstration of the impact of the osseous fluctuation markers PINP on the one hand and β-CTx on the other hand for the verification of bone metastases in female patients suffering from breast cancer. PINP is a marker for bone generation and specific indicator of type I collagen deposition. β-CTx are delivered as disruption artefacts of collagen type I and therefore able to be detected in serum and urine.
Objectives: The main objective of the following thesis was the evaluation of the significance of bone markers β-CTx and PINP regarding their advantage for matutinal recognition of osseous expansion and pathological skeletal reorganization in pre- and postmenopausal breast cancer patients. Patients, Materials and Methods: Peripheral blood samples of each 80 patients with known breast neoplasm were amassed and the bone markers PINP and β-CTx quantified. Therefore we used a specific immunoassay “ECLIA” and the analysis approach ELECSYS 2010 and COBAS e by Roche Diagnostics (Mannheim, Germany). Our groups of patients were divided with regard to menopausal and bone metastases status. Results: By contrast with the group devoid of bone involvement with a median of 73.61ng/ml there are significant higher serum concentrations of PINP in the female collective with scintigraphically verified skeletal metastases with a median of 125.75ng/ml. In any case, both populations revealed data above the provided cutoff values (premenopausal → 27.8ng/ml and postmenopausal → 37.1ng/ml).For β-CTx the study depicted similar results: β-CTx provided a specificity and sensitivity of 100.0%. An increased β-CTx level was connected significantly with osseous metastases in our study collectives (median: 67.0ng/ml) in contrast to the bone metastases-negative population (median: 0.905ng/ml). Moreover there were also significant differences concerning the menopausal degree of development of patients (p < 0.001). Conclusion: Summing up the markers of bone turnover PINP and β-CTx could be considered as useful and helpful diagnostic tools for detecting bone involvement in patients with known breast carcinoma. As indicators for bone metabolism, formation and resorption they are up to externalize a significant discrimination between breast cancer patients with and without bone infestation. In addition they seem to be beneficial to ascertain these sick persons with early dysfunctions in skeletal metabolism and help to initiate premature attendance. It is an important discussion point whether these bone markers are capable to supplant conventional procedures for the registration of bone metastases like the radiological ones.Keywords: Beta-crosslaps, bone formation, bone involvement, bone marker, bone metastases, bone resorption, bone turnover, breast cancer, β-CTx, malignancy, PINP, procollagen type I aminoterminal propeptide, tumor marker.
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