THE DIAGNOSTIC-VALUE OF URINARY CROSSLAPS AND SERUM ALKALINE-PHOSPHATASE IN PATIENTS WITH PROSTATE-CANCER

Objective To determine whether the urinary excretion of Crosslaps and serum alkaline phosphatase (ALP) are useful bone markers in patients w ith prostate cancer. Patients and methods The study included 112 patie nts, comprising 25 with benign prostatic hyperplasia and 87 with carci noma of the prostate, 41 of whom had localized prostate cancer and 46 with bone metastases. in the last group, 16 were stable and 30 were in clinical progression. Prostate-specific antigen (BSA) and the bone ma rkers serum bone ALP and urinary Crosslaps were determined on the same day. Results The rates of excretion of Crosslaps were significantly g reater in patients with than in those without bone metastases. Only Cr osslaps showed a significant difference between patients with stabiliz ed metastatic disease and those with no bone involvement. Crosslaps ha d a higher specificity and positive predictive value than had PSA leve l in patients with bone metastases, and a higher sensitivity than bone ALP. Conclusion These preliminary findings suggest that Crosslaps may be useful as an additional bone marker in patients with prostate canc er and may provide information of the metastatic spread to bone in the se patients. Prospective studies with serial measurements of bone mark ers are currently underway to relate these results to the progression of disease and to evaluate the response to treatment of bone metastase s.