Serum Bone Turnover Markers in Patients with Primary Bone Tumors

Abstract

Objectives: It was the aim of this study to investigate parameters of bone turnover such as serum bone-specific alkaline phosphatase (BALP) and N-terminal midfragment of osteocalcin (N-MID), as well as serum C-terminal telopeptide of type I collagen (CTX) in patients with primary bone tumors and to investigate their validity in differentiating malignant from benign bone tumors. Methods: A total of 219 patients with primary bone tumors entered the study. The patients were divided into 2 groups according to their age, including a teenage (10–19 years old) and an adult group (≧20 years old). In each group, the patients were divided into several subgroups (osteosarcoma, benign bone tumors or tumor-like lesions, giant cell tumor, and other primary malignant bone tumors). An age- and gender-matched control population was also studied in each group. Blood samples were taken for measurement of serum BALP, N-MID and CTX. Results: The serum BALP levels in patients with osteosarcoma were significantly higher than those of patients in the other subgroups and the controls, both in the teenage (p = 0.01) and the adult group (p = 0.000). The serum N-MID and CTX levels did not significantly differ among patients of different subgroups and the controls, both in the teenage (p = 0.773 and p = 0.747, respectively) and the adult group (p = 0.163 and p = 0.074, respectively). Conclusions: A high serum BALP level is valuable for the diagnosis of adult osteosarcoma, but its use in the development of a differential diagnosis in the teenage patients is not advised because serum BALP levels are also affected by age, pubertal stage and growth velocity. Both serum N-MID and serum CTX are hardly useful in the differential diagnosis of primary bone tumors.

Clinical Characteristics and Evolution of Giant Cell Tumor Occurring in Paget's Disease of Bone

“…Of interest, PDB-GCT patients had generally elevated serum ALP levels at GCT onset even though many had previously received pharmacological treatment for PDB, whereas in adult patients with GCT alone (without PDB) ALP levels where not different compared to controls. (23) This observation suggests that GCT generally complicates a longstanding, active, and polyostotic PDB and is consistent with our previous remarks. (14) One cannot, however, exclude that high ALP levels are caused by GCT directly eroding bone.…”

“…In patients without PDB, GCT occurs in young adults, most often between 20 and 40 years of age, whereas pagetic GCT generally occurs after the fourth decade of life. Of interest, PDB‐GCT patients had generally elevated serum ALP levels at GCT onset even though many had previously received pharmacological treatment for PDB, whereas in adult patients with GCT alone (without PDB) ALP levels where not different compared to controls . This observation suggests that GCT generally complicates a longstanding, active, and polyostotic PDB and is consistent with our previous remarks .…”

High serum alkaline phosphatase cooperating with MMP-9 predicts metastasis and poor prognosis in patients with primary osteosarcoma in Southern China

“…Peak values occur at puberty, perhaps due to high skeletal growth velocity and rapid bone turnover during this period [25,26]. However, all the studies before [8,26,27] do not stratify for these differences, so the effect of age on ALP levels can not be evaluated. In our study, the age of patients ranged from 6 years to 56 years.…”

Bone Turnover Markers in the Diagnosis and Monitoring of Metabolic Bone Disease

“…Osteoid osteoma has been proposed to secrete OC (83 ). Bone ALP can be secreted from osteosarcoma, and high bone ALP has been observed in patients with osteosarcoma (84 ). However, bone ALP levels have been proposed to have greater diagnostic utility for detection of osteosarcoma in adult vs adolescent onset osteosarcoma due to the lower baseline variability of bone ALP levels in adults.…”