Postoperative PINP in serum reflects metastatic potential and poor survival in node-positive breast cancer

The aim of this work was to evaluate the postoperative serum markers of typ e I collagen synthesis (PINP,PICP) and degradation (ICTP) and their possibl e potential for predicting the spread of disease and survival. 373 node-pos itive breast cancer patients were enrolled. 120 patients (32%) developed re current disease in the follow-tip, The mean time to recurrence was 17 month s and the mean follow-up time was 45 months. The mean level of PINP was sig nificantly elevated in the patients who developed metastatic disease in the follow-tip as compared with those without metastases. PINP was statistical ly significantly higher in all the patients who developed bone metastases t han in those without metastases. When patients with only bone metastases or patients with bone and soft tissue and/or visceral metastases and patients with only visceral or soft tissue metastases were compared with those not exhibiting metastases, PINP was significantly higher in the group with recu rrence in the bone, but there were no significant differences in serum PINP , PICP or ICTP values between the patients with only bone metastases and th ose who developed soft or visceral metastases during the follow-up. Postope rative high PINP was also a factor for poorer survival. Tumor size, maligna ncy grade and progesterone receptors were shown in multivariate analysis to be predictors of recurrence and tumor size and PINP and progesterone recep tors to be predictors of survival.