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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