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The clinical importance of bone metabolic markers in detecting bone metastasis of lung cancer

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Abstract

Aim

The aim of this study was to evaluate the role of bone metabolic markers in clinical evaluation of bone metastasis of lung cancer.

Materials and methods

Sixty-five male patients with lung cancer were included in this trial, 77% of whom were diagnosed as having non-small cell lung cancer and 20% were small cell lung cancer. The presence of bone metastasis was investigated by whole-body bone scintigraphy via Tc-99m mostly (80%) and, in some cases, PET/CT (positron emission tomography and computerized tomography) which was performed for staging. Bone-specific alkaline phosphatase (BALP) and osteocalcin were measured in serum of the patients as markers of bone formation. N-terminal telopeptide (NTX) and β-form of C terminal telopeptide (β-CTX) were studied as bone destruction markers.

Results

The cases were divided into two groups according to the presence of bone metastasis. Twenty-three patients (35%) had bone metastasis. Serum levels of total ALP, BALP and NTX were significantly higher in the group with bone metastasis (p < 0.05). Osteocalcin and β-CTX levels were not significantly different between two groups. According to ROC-curve analysis, at the threshold value of 22.38 μg/L, the sensitivity of BALP was 60.87% and the specificity was 69.05%. Similarly, at the threshold value of 25.69 nmol BCE, the sensitivity of NTX was 90.24% and the specificity was 43.4%.

Conclusion

Bone metabolic markers are considered noninvasive, useful and cost-effective. However, more prospective studies are needed in order to use them for evaluation of bone metastasis in lung cancer.

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Conflict of interest

No author has any conflict of interest.

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Authors and Affiliations

  1. Department of Pulmonary Medicine, School of Medicine, Adnan Menderes University, Aydin, Turkey

    Suna Bilgin Bayrak, Emel Ceylan, Fisun Karadağ & Orhan Çildağ

  2. Department of Biochemistry, School of Medicine, Adnan Menderes University, Aydin, Turkey

    Mukadder Serter & Ece Demir

  3. Department of Chest Diseases, Faculty of Medicine, Adnan Menderes University, 09100, Aydin, Turkey

    Emel Ceylan

Authors
  1. Suna Bilgin Bayrak
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  2. Emel Ceylan
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  3. Mukadder Serter
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  4. Fisun Karadağ
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  5. Ece Demir
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  6. Orhan Çildağ
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Corresponding author

Correspondence to Emel Ceylan.

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Bayrak, S.B., Ceylan, E., Serter, M. et al. The clinical importance of bone metabolic markers in detecting bone metastasis of lung cancer. Int J Clin Oncol 17, 112–118 (2012). https://doi.org/10.1007/s10147-011-0266-7

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  • DOI: https://doi.org/10.1007/s10147-011-0266-7

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