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Diagnostic and Prognostic Use of Bone Turnover Markers

  • Chapter
  • First Online:
Prevention of Bone Metastases

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 192))

Abstract

The use of bone turnover markers in oncology includes monitoring of anticancer treatment in patients with malignant disease metastatic to the bones (therapeutic monitoring), predicting the risk of bone relapse in patients with a first diagnosis of potentially curative, early-stage malignant tumors (prognostic use), and making an early diagnosis of (microscopic) malignant bone disease in patients with a known malignant tumor to start early bone-targeted treatment and avoid skeletal-related events (diagnostic use). Concerning prognostic use, there is limited evidence for bone turnover markers to predict the occurrence of metachronous bone metastases in patients with early-stage malignant tumors, with serum PINP (N-terminal propeptide of procollagen type 1), ICTP (Carboxyterminal cross-linked telopeptide of type I collagen), bone sialoprotein (BSP), and tumor immunoexpression of BSP being the most promising candidates. Concerning diagnostic use, serum bone-specific alkaline phosphatise (BSAP), PINP and osteoprotegerin (OPG) were repeatedly shown to be associated with synchronous bone metastases in patients with breast or lung cancer, but sensitivity of these markers was too low to suggest that they might be preferred over conventional bone scans for the diagnosis of bone metastases. A somewhat higher sensitivity for the diagnosis of bone metastases was found for urinary NTx (N-terminal cross-linked telopeptide of type I collagen) and serum ICTP in solid tumor patients, serum TRAcP-5b (Tartrate-resistant acid phosphatase type 5b) in patients with breast cancer and serum BSAP, PINP and OPG in prostate cancer patients. Both prognostic and diagnostic use of bone turnover markers are reviewed in this chapter.

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  1. Department of Medical Oncology and Breast Centre, Cantonal Hospital, St. Gallen, Switzerland

    Markus Joerger & Jens Huober

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Correspondence to Markus Joerger .

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  1. , Dept. of Medical Oncology, Kantonsspital St. Gallen, Rorschacherstr. 95, St. Gallen, 9007, Switzerland

    Markus Joerger

  2. Chirurgische Klinik, Abt. Allgemeine Chirurgie, Universitätsklinikum Wien, Währinger Gürtel 18-20, Wien, 1090, Austria

    Michael Gnant

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Joerger, M., Huober, J. (2012). Diagnostic and Prognostic Use of Bone Turnover Markers. In: Joerger, M., Gnant, M. (eds) Prevention of Bone Metastases. Recent Results in Cancer Research, vol 192. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-21892-7_10

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  • DOI: https://doi.org/10.1007/978-3-642-21892-7_10

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