Pretreatment levels of urinary deoxypyridinoline as a potential marker in patients with prostate cancer with or without bone metastasis

Objective To assess the predictive role of the bone markers alkaline phosph atase (ALP) and urinary deoxypyridinoline (DPD), as indicators of bone turn over, at baseline in patients with prostate cancer. Patients, subjects and methods Urinary DPD, serum ALP and prostate-specific antigen (PSA) were evaluated in 23 patients with benign prostatic hyperpla sia (BPH), 115 with prostatic carcinoma, of whom 21 had bone metastasis, an d in 16 age-matched control subjects. Results Patients with newly diagnosed prostate cancer and bone metastasis h ad a higher urinary excretion of DPD, and a higher serum PSA and ALP than h ad patients with BPH and those with prostate cancer but no metastasis. Rece iver operating curve analysis for PSA, ALP and DPD showed a significant dis criminating ability for positive and negative bone scans (P=0.0684). Howeve r, from logistic regression of the combinations, only serum ALP was a signi ficant independent predictor of bone metastasis in patients with prostate c ancer. Conclusion Serum ALP or urinary DPD are the best predictors of bone metasta sis in patients with prostate cancer; further studies with more patients ar e required.