[Evaluation of cancer-induced bone diseases by bone metabolic marker]

Recently, several new bone metabolic markers have been developed and applied for diagnosis of bone metastasis. We have investigated the efficacy of several bone metabolic markers : serum carboxy-terminal telopeptide of type 1 collagen ( I CTP), C-terminal cross-linked telopeptide of type I collagen (CTX) and urinary free deoxypyridinoline (fDPD) as bone resorption markers, serum carboxy-terminal propeptide of type 1 collagen (P I CP), osteocalcin (OC), and bone alkaline phosphatase (BAP) as bone formation markers for diagnosis of bone metastasis. I CTP was most useful for diagnosis of bone metastasis in breast cancer patients because of no increase in postmenopausal osteoporosis. Combination of resorption and formation markers increased sensitivity. In follow-up, bone metabolic markers seemed more useful for predicting therapeutic response of bone metastasis than tumor markers. Bone metabolic markers were also useful for predicting survival or occurrence of skeletal-related events. These findings suggest that bone metabolic markers would be useful to detect, to monitor, and to predict prognosis of bone metastases.