USEFULNESS OF BONE METABOLIC MARKERS IN THE DIAGNOSIS AND FOLLOW-UP OF BONE METASTASIS FROM LUNG-CANCER

Ninety-one lung cancer patients were evaluated to determine the useful ness of bone metabolic markers in the diagnosis and follow-up of bone metastases and also to investigate their clinical usefulness as an adj unct to bone scintigraphy. Both bone resorption markers, ICTP and fDPD , and bone formation markers, Al-p, BAL, PICP and BGP, were evaluated in 47 patients with and 44 without bone metastasis. The patients with bone metastasis were classified according to the bone metastatic burde n, and they were also separately classified into groups according to t he course of the bone metastasis. ICTP, fDPD, Al-p and BAL were signif icantly elevated (P < 0.001) in patients with bone metastasis, but PIC P and BGP were not. Receiver-operating characteristic (ROC) curves of these markers revealed that ICTP was most highly correlated with the d iagnosis of bone metastasis. The sensitivity of ICTP (71.4%) and fDPD (61.0%) were good with high specificity. T scores of ICTP, fDPD and BA L tended to be higher at higher grades of bone metastasis. T-scores of ICTP, fDPD and BAL were elevated in the newly diagnosed cases and pro gressed cases, but the T-scores of ICTP and fDPD in those cases were h igher than that of BAL. In the follow-up study, ICTP was well correlat ed with uncontrolled or controlled bone metastasis. Thus, bone resorpt ion markers, especially ICTP, could be a good indicator of the progres sion and multiplicity of disease, and it could help in the follow-up a nd in the monitoring of therapy for bone metastasis from lung cancer.