PATIENTS AND METHODS: 305 patients were examined. 145 had histologically confirmed BC (92 with bone
metastases), 20 UBC (6 with bone
metastases), 11 LC (3 with bone
metastases) and 129 PC (68 with bone
metastases). In BC patients we compared the
PICP and ICTP levels with those of CA 15-3, CEA and bone scintigraphy. Patients with LC and UBC had
PICP and ICTP measurements, PC patients had serum
PICP,
prostate specific antigen (PSA) measurements and bone scans. 104 healthy individuals served as controls.
RESULTS: ICTP and CA 15-3 levels were significantly higher in patients with BC and bone
metastases in comparison to patients without
metastases (p <0.05), while
PICP and CEA were only marginally higher. Significant correlation was observed between existence of bone
metastases and ICTP levels (p <0.05). The sensitivity of
PICP, ICTP, CEA and CA 15-3 was 28.1, 48.6, 42, and 78%, respectively and specificity was 83.9, 94, 65 and 86%, respectively. ICTP and CA 15-3 were the most reliable markers for early diagnosis of bone
metastases in BC.
PICP alone or with ICTP were not sensitive enough. Only CA 15-3 showed sensitivity 78% and specificity 86%. When combined CA 15-3, ICTP and CEA the sensitivity and specificity increased to 82% and 96%, respectively. Furthermore,
PICP and PSA levels were significantly higher in patients with PC and bone
metastases in comparison to patients with benign prostate
hyperplasia (BPH) (p <0.0001) or in patients with PC without bone
metastases (p <0.0005 for
PICP and p <0.0001 for PSA). The co-evaluation of
PICP and PSA improved the sensitivity (78%), specificity (96%), accuracy (97%) and positive predictive value (97%). In LC patients, ICTP levels differed significantly between patients with and without bone
metastases (p=0.025). In UBC patients,
PICP levels differed significantly between patients with and without bone
metastases (p=0.017).
CONCLUSION: ICTP and CA 15-3 are the most reliable markers for early diagnosis of bone
metastases in BC patients.
PICP could be useful for diagnosing early bone
metastases of PC and combined with PSA and bone scan can be an additional tool in the follow-up of PC patients. For LC patients, ICTP showed a significant difference in the discrimination of patients with and without bone
metastases. In UBC patients,
PICP showed a significant difference in the discrimination of patients with and without bone
metastases.