Research On Oxypyridinoline In Diagnosis And Treatment Of Osseous Metastasis Of Lung Cancer

BackgroundMany malignant tumor could generate osseous metastasis, cause pain, hypercalcinemia or pathological fracture . These phenomenon frequently happen in carcinoma of prostate, breast carcinoma and lung cancer, and so on. Radioisotope scanning is always used to monitoring and diagnosis in osseous metastasis of tumor, dynamic observation on change of osseous metastasis is expensive, detection is complicated, change of metastasis is very difficultly fund. Detction of X-ray and CT could diagnose osseous metastasis when sclerotin destruction and decalcification achieve some extent. And then pathogenetic condition is always in advanced stage.How to make easier diagnosis and dynamic obervation on tumor s osseous metastasis and how to monitor change of osseous metastasis after treatment and therapeutic efficacy is important issue of clinical oncolgy now.DPD ( Deoxypryidinoline) is more and more taken on a index on ealy dianosis and therapeutic effect of malignant tumor s osseous metastasis. DPD in urina is a special and sensive biochemistry index. We observe and investigate DPD s significance in diagnosis and therapy estimation of osseous metastasisof lung cancer.Method1 182 cases with lung cancer through preliminary diagnosis included 102 cases with osseous metastasis and 80 cases without osseous metastasis. Two groups have no significant difference in sex, age and pathology. uDPD/C, uCa/Cr, sCa and sAKP were detectedand compared in two groups. Sensitivity and specificity of various indexs in osseous metastasis of lung cancer were in statistics in group with osseous metastasis. Dynamic observation of uDPD and ECT in group without osseous metastasis were carried out. 2 uDPD/Cr, uCa/Cr, sCa and sAKP were detected after two weeks of therapy with bolin, I53Sm-EDTMP and chemical Chem and compared with these indexes before therapy in 81 cases with osseous metastasis. 32 cases with osseous metastasis could be estimated in curative effect. Those cases were divided into different groups and uDPD/Cr before therapy was compared with the one after thepapy among various groups.Conclusion1 uDPD/Cr of group with osseous metastasis and without osseous metastasis is 12.35 + 2.65nmol/ mmol and 7.76±2.11nmol/ mmol respectively. uDPD/Cr of group with osseous metastasis is higher than the one of group without uDPD/Cr of group with osseous metastasis and the difference is significant in statistics. sCa and sAKP of group with osseous metastasis is higher than those of group without osseous metastasis and the difference is significant in statistics. The difference of uCa/Cr of two groups is not significant(p>0.05).2 The sensitivity and specificity of uDPD/Cr, sAKP, sCa, uDPD/Cr in diagnosis of osseous metastasis of lung cancer are 86% and 65%, 21% and 56%,47% and 46% respectively. The sensitivity and specificity of uDPD/Cr are both high.3 uDPD/Cr of 25 cases with osseous metastasis of lung cancer before therapy of bolin is 13.37 + 2.65 nmol/ mmol and 7.34 + 2.15 nmol/ mmol after therapy. uDPD/Cr obviously decrease after therapy and the difference is significant in statistics. uDPD/Cr of 26 cases with osseous metastasis of lung cancer before therapy of 153Sm-EDTMP is 12.34 + 2.63 nmol/ mmol and is 8.25 + 2.41 nmol/ mmol after therapy of 153Sm-EDTMP.The difference is significant(P<0.05). uDPD/Cr of 30 cases with osseous metastasis of lung cancer before Chem with GP or EP project therapy is 12.85 + 2.52 nmol/ mmol and is 8.43 + 2.63 nmol/ mmol.The difference is significant. uDPD/Cr of three groups obviouslybreakdowned after different therapies. The difference of uCa/cr of three groups is not significant before therapy in contrast to that after therapy. sAKP of the group cured by I53Sm-EDTMP is 80.25 + 27.03u/ L ,but is 115.24 + 20.05u/ L prior treatment. And the difference is significant, but that is not significant in groups of bolin therapy and Chem(P>0.05). The difference of sCa in groups of bolin and 153Sm-EDTMP before and after therapy are significant(P<0.05), but that is not significant in Chem group(P>0.05).4 Cases of CR, PR, NC and PD is 0 case, 6cases,14 cases and 12 cases respctively among 32 cases of osseous metastasis of lung cacinoma that could be estimated. Uility group include 20 cases, useless group is 12 cases. The difference of uDPD/c of two groups before therapy is not significant and is significant after therapy.5 Dynamic observation of uDPD/Cr and ECT were carried out among 80 cases of lung cancer without osseous metastasis. These result revealed that 46 cases is normal and 34 cases is high in uDPD/Cr. uDPD/Cr of 6 cases is between 8 and 9nmol/ mmol, that of 17 cases is between 9 andlO nmol/ mmol, that of 11 cases exceed 10 nmol/ mmol. Dynamic observation and tracing of 6 monthes reveal that : 8 cases generate osseous metastasis in group of normal uDPD/Cr and rate of osseous metastasis is 17.4%. Osseous metastasis happened in 19 cases in group of high uDPD/Cr, rate of osseous metastasis is 55.9%. The difference of rate of osseous metastasis among two groups is significant. The rate of osseous metastasis is 33.3% among those cases whose uDPD/Cr is between 8 and 9 nmol/ mmol and that is 53.9% among cases whose uDPD/Cr is bwteen 9 and 10 nmol/ mmol and that is 72.7% among cases whose uDPD/Cr exceed 10 nmol/ mmol. osseous metastasis happening concentrate betwween 2 and 4 monthes among cases in group with high uDPD/Cr, but between 5 and 6 monthes among cases in group with mormal uDPD/Cr.ResultuDPD/Cr is a type of special and sensitive biochemical marker of bone resorption.We find that uDPD in group of osseous metastasis of lung cancer is higher than that in group without osseous metastasis. The sensitivity and speciality of uDPD(DPD/cr>9nmol/mol) in diagnosis of osseous metastasis of lung cancer. If uDPD/Cr increase in cases without osseous metastasis, osseous metastasis might happen and uDPD/Cr is more high ,the rate of osseous metastasis is more high. UDPD has larger clinical significance in early diagnosis of osseous metastasis of lung cancer. uDPD/Cr of cases with osseous metastasis obviously decrease after therapy of bolin, isotope and Chem. The conclusion made by uDPD/cr in estimation of osseous metastasis of lung cancer is coininsidnce with that made by traditional method. uDPD/cr might be a useful reference index in estimating therapeutic efficacy of osseous metastasis of lung cancer and it might be worth further researching.