Efficacy of simultaneous determination of bone alkaline phosphatase mass concentration in serum and urinary excretion of pyridinium cross-links for detection of bone metastases.

Abstract

OBJECTIVES:

To examine the diagnostic validity of bone alkaline phosphatase (BAP) in serum (a marker of bone formation) and of urinary excretion of pyridinium cross-links (PYR) (a marker of bone resorption) for detection of bone metastases.

DESIGN AND METHODS:

Two heterogeneous immunoassays were employed for determination of BAP mass concentrations (Tandem-R Ostase) in serum and the urinary excretion of PYR (Collagen Crosslinks) in a consecutive series of 89 tumor patients examined by bone scintigraphy (with 99mTc-methylene diphosphonate).

RESULTS:

The discrimination power (as determined by Z score analysis) and the accuracy (as assessed by the area under the receiver-operating characteristic curve) was higher for BAP (0.84) than for PYR (0.76). Combination of both markers yielded a further increase of accuracy (0.89). There was a correlation (r = +0.422; p < 0.001) between the urinary excretion of pyridinium cross-links and bone alkaline phosphatase mass concentrations in the whole of 89 patients examined. In 14 (16%) of 89 patients bone alkaline phosphatase values were within the reference interval in spite of total alkaline phosphatase activity being increased; this indicates a higher diagnostic specificity of bone alkaline phosphatase (compared with total alkaline phosphatase) with respect to detection of bone metastases.

CONCLUSION:

Simultaneous assessment of bone formation by BAP and of bone resorption by PYR provides a suitable tool for detection of bone metastases.

• Authors: W Withold, G Georgescu, H Khakzad, H Vosberg, H W Mueller-Gaertner, H Reinauer
• Journal: Clinical biochemistry (Clin Biochem) Vol. 28 Issue 5 Pg. 511-9 (Oct 1995) ISSN: 0009-9120 [Print] United States
• PMID: 8582050 (Publication Type: Journal Article)

Chemical References

• Isoenzymes
• Pyridinium Compounds
• Alkaline Phosphatase

Topics

• Adult
• Aged
• Alkaline Phosphatase (blood)
• Bone Neoplasms (diagnosis, secondary)
• Bone Resorption
• Bone and Bones (enzymology)
• Electrophoresis, Agar Gel
• Female
• Humans
• Isoenzymes (analysis, metabolism)
• Male
• Middle Aged
• Osteogenesis
• Pyridinium Compounds (urine)
• ROC Curve
• Regression Analysis