Efficacy of Skeletal Alkaline Phosphatase and Prostate-Specific Antigen in the Diagnosis of Bone Metastasis in Cancer of the Prostate

Abstract

Purpose: To study the efficacy of prostate-specific antigen (PSA) and skeletal alkaline phosphatase (SAP) as staging markers in discriminating patients with cancer of the prostate (CaP) with (M+) and without bone metastases (M0). Material and Methods: 73 patients with untreated CaP entered the study. After staging the patients were divided into 3 groups: group I, patients with CaP and bone metastases (n = 21); group II, patients with locally advanced CaP without bone metastases (n = 26), and group III, patients with clinically localized CaP without bone metastases (n = 26). Results: None of the M0 patients but 71% of the M+ patients exhibited an increased SAP. A corresponding cutoff point of 100 ng/ml for PSA showed that 19% of M0 patients and 71% of the M+ patients exhibited a value of >100 ng/ml. This resulted in a sensitivity and specificity of 71 and 100% of SAP and 71 and 81% for PSA, respectively. Conclusion: SAP could become a useful marker in the evaluation of patients with newly diagnosed CaP as it provides additional information concerning the skeletal status of these patients.

Identification of Serum Amyloid A as a Biomarker to Distinguish Prostate Cancer Patients with Bone Lesions

“…The ideal biomarker should have low false-positive and -negative rates and be sensitive, specific, quantifiable, and capable of detecting tumors at an early stage to allow appropriate therapy and prognostic reference and to predict the likelihood of recurrence (41,42 ). Serum PSA is a good biomarker for monitoring progression of hormone-refractory prostate cancer, but it cannot distinguish bone metastases from local recurrence or soft tissue secondary lesions (12,43 ). Absolute PSA concentrations in recurrent disease have not consistently been shown to be prognostic for survival or predictive of response.…”

“…One of the best applications of serum PSA measurements is for the monitoring of treatment response and relapse in prostate cancer patients. However, serum PSA concentrations cannot predict the presence of bone or soft tissue metastases (12 ). At the molecular level, PSA gene expression is regulated by the androgen receptor via androgen response elements (13 ).…”

Serum cross-linked n-telopeptides of type 1 collagen (NTx) in patients with solid tumors

“…6 Alkaline phosphatase has several isoforms, including bone alkaline phosphatase (bone ALP), which is produced by osteoblasts and usually contributes about 40% of the total circulating ALP. 6 In fact, bone ALP is specific for the detection and follow-up of bone diseases that lead to new bone formation, such as BM, in several series in the literature dealing with specific tumor types such as breast, 7 prostate 8,9 and lung carcinomas. 10 Since BMs induce higher rates of bone resorption, in addition to increased bone formation, evaluation of bone resorption markers in patients with solid tumors who are prone to develop BMs is of interest.…”

‘Nurse: My back hurts!’: case study review of Degarelix in metastatic prostate cancer

“…ALP, as a non-specific marker of osteoblast activity (Cook et al, 2006), is elevated in 70% of patients with bone metastases (Wolff et al, 1999) and should be considered in patients suspected to have metastatic disease. Although raised ALP can also indicate liver metastases (Fontana and Delmas, 2000), these are uncommon in men with prostate cancer (Poussel et al, 2007).…”