| ObjectiveTo study the value of serum marker NTx level in lung cancer with bone metastasis. To detect the relationships between symptoms and serological indicators of bone metastatic lesion. Find a serological diagnostic indicators which can predict the bone metastasis, and serve for the clinical diagnosis and treatment.Methods1. SubjectSelected 78 cases of lung cancer from 2009-11 to 2010-11 in Liaocheng People's Hospital.56 cases were male and 22 females, ages 40-80 years old, obtained the pathologic diagnosis by surgery,bronchoscopy,sputum, or pleural effusion cytology. adenocarcinoma 32 cases (41.3%), squamous cell carcinoma 15 cases(19.2%), mixed type 4 cases (5.1%), small cell lung cancer 21 cases (26.9%), other 6 cases(7.5%) .all cases were confirmed by X-ray,ECT,CT or MR.2. Group(1). Method one: All cases divided into none bone metastasis group and bone metastasis group. Bone metastasis to meet: ECT suggestive of metastatic lesions, and confirmed by CT or MR .none bone metastasis: bone scan examination found no metastasis within 1 month. the following cases were removed: 1 year before enrollment traumatic fracture patients ,with endocrine disorders affecting bone metabolism (such as disorders in thyroid and parathyroid function, poorly controlled diabetes, rheumatoid arthrosis or osteoarthrosis), within one month uses dugs affected bone metabolism (such as bisphosphonates), radiotherapy for bone metastasis .(in this study than the control group set itself.) The average age of patients in each group for statistical comparison;(2). Method two: Selecte 8 cases of bone metastasis has occurred. before and after anti-bony metastasis treatment serum samples were collected, results were statistically analyzed.3. Specimen collectionAfter admission, collecte 2ml blood in the early morning, serum after centrifugation reserved in -80℃refrigerator; enzyme-linked immunosorbent assay of serum NTx, operation carried out in strict accordance with product instructions, Set the blank experiment and control groups in order to ensure the reliability of results.4. Statistical analysisStatistical software used SPSS 17.0. Measurement data were mean±standard deviation ( x±s). the two sample of bone metastasis group and non-bone metastasis group applied t- test for statistical analysis; the different Patholog- ical grups applied the Kruskal-Wallis test analysis;the treatment of bone metastasis in 8 cases before and after pairing t-test. P<0.05 as significant difference.Results1. The level of serum NTx in bone metastasis group was significantly higher than the group of non-bone metastasis,0.02<P<0.03, the difference was statistically significant;2. All the cases which were divided into 5 groups according to the pathological type, applied Kruskal-Wallis test, P<0.01;serum NTx in adenocarcinoma grup was significantly higher than other pathological types.3. 41 cases with bone metastasis were divided into different grups according to pathological types, applied Kruskal-Wallis test, P<0.01; the level of serum NTx in adenocarcinoma group was significantly higher than other groups ;4. 8 cases underwent self-control, to observe the variation of the NTx before and after application of bisphosphonates. P<0.01, the difference was statistically significant.5. Serum NTx level in the bone metastasis, diagnostic sensitivity and specificity degrees calculation , the result was : When cut off value was 40.95nmol/L, bone metastasis diagnosis sensitivity was 84. 0%, specificity was 63.9%; When cut of value was 80.38 nmol/L, sensitivity was 90.0%, specificity was 74.3%;6. In bone metastasis patients, correlation analysis were underwent between NTx level and bone metastasis number, position,digree of pain. Results: NTx concentration and digree of pain existed a positive correlation (P<0.01); But no significant correlation with the number and bone metastasis position. SRE patients (especially happen happened the pathologic fracture patient) is obviously higher than none bone metastasis patients (P<0.05);7. 37 cases none bone metastasis follow-up 6～12 months, there are 16 patient occurred bone metastasis, the median time was 5.5 months. Cox's proportional hazards regression model analysis of bone metastasis risk factors (age, ecogphysical condition, serum NTx). Results: the age and serum NTx concentration were impact factors lung cancer patients occurred bone metastasis. risk ratio was 1.157 (95% for the credibility of 1.035～1.198), Serum NTx concentration level goes up grup, the risks of bone metastasis increased 12.7% . there is statistical significance (P<0.01).Conclusions1. In bone metastasis Lung cancer patients ,the serum NTx significantly higher than in none bone metastasis.2. Serum NTx levels in adenocarcinoma lung cancer patients were significantly higher than the other Pathological types levels of serum patients;3. Serum NTx significantly affected by Bisphosphonates in bone metastasis patients ,can be used as indicator of clinical observation;4. NTx concentration with the digree of pain existed a positive correlation; But no significant correlation with the number and bone metastases position. SRE patients (especially happen happened the pathologic fracture patient) is obviously higher than none bone metastasis patients.5. Age is a impact factor of serum NTx concentration. |
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