中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
12期
117-119
,共3页
乳腺癌%骨转移%生化指标
乳腺癌%骨轉移%生化指標
유선암%골전이%생화지표
Breast cancer%Bone metastasis%Bone metabolic markers
乳腺癌是一种容易引起骨转移的女性常见的恶性肿瘤,其机制以溶骨性骨转移为主.在正常骨代谢中,由成骨细胞介导的骨形成作用和由破骨细胞介导的骨吸收作用之间呈动态平衡,而发生骨转移时,转移的肿瘤细胞可打破这种平衡,并引起相应骨代谢指标的改变,而这种改变可通过血液及尿液化验检测.近年来研究的骨特异性标记物可总结为骨吸收标记物及骨形成标记物,前者包括抗酒石酸酸性磷酸酶(TRACP)异构体5b,Ⅰ型胶原吡啶交联终肽(ICTP),Ⅰ型胶原蛋白交联氨基末端肽和羧基末端肽(NTx/CTx)及吡啶酚(PYD)和脱氧吡啶酚(D-PYD).后者包括骨特异性碱性磷酸酶(BAP),Ⅰ型前胶原氨基端前肽(PINP)和Ⅰ型前胶原羧基端前肽(PICP)、骨唾液酸蛋白(BSP)、骨钙素(OC)等.这些实验室检测为早期乳腺癌骨转移的诊断提供了更多的依据.
乳腺癌是一種容易引起骨轉移的女性常見的噁性腫瘤,其機製以溶骨性骨轉移為主.在正常骨代謝中,由成骨細胞介導的骨形成作用和由破骨細胞介導的骨吸收作用之間呈動態平衡,而髮生骨轉移時,轉移的腫瘤細胞可打破這種平衡,併引起相應骨代謝指標的改變,而這種改變可通過血液及尿液化驗檢測.近年來研究的骨特異性標記物可總結為骨吸收標記物及骨形成標記物,前者包括抗酒石痠痠性燐痠酶(TRACP)異構體5b,Ⅰ型膠原吡啶交聯終肽(ICTP),Ⅰ型膠原蛋白交聯氨基末耑肽和羧基末耑肽(NTx/CTx)及吡啶酚(PYD)和脫氧吡啶酚(D-PYD).後者包括骨特異性堿性燐痠酶(BAP),Ⅰ型前膠原氨基耑前肽(PINP)和Ⅰ型前膠原羧基耑前肽(PICP)、骨唾液痠蛋白(BSP)、骨鈣素(OC)等.這些實驗室檢測為早期乳腺癌骨轉移的診斷提供瞭更多的依據.
유선암시일충용역인기골전이적녀성상견적악성종류,기궤제이용골성골전이위주.재정상골대사중,유성골세포개도적골형성작용화유파골세포개도적골흡수작용지간정동태평형,이발생골전이시,전이적종류세포가타파저충평형,병인기상응골대사지표적개변,이저충개변가통과혈액급뇨액화험검측.근년래연구적골특이성표기물가총결위골흡수표기물급골형성표기물,전자포괄항주석산산성린산매(TRACP)이구체5b,Ⅰ형효원필정교련종태(ICTP),Ⅰ형효원단백교련안기말단태화최기말단태(NTx/CTx)급필정분(PYD)화탈양필정분(D-PYD).후자포괄골특이성감성린산매(BAP),Ⅰ형전효원안기단전태(PINP)화Ⅰ형전효원최기단전태(PICP)、골타액산단백(BSP)、골개소(OC)등.저사실험실검측위조기유선암골전이적진단제공료경다적의거.
Breast cancer ranks among the most prevalent malignancies in women to cause bone metastasis,which the main mechanism is osteolytic bone metastasis.There is a balance between the formation of new bone by osteoblasts and the resortion of old bone by osteoclasts in normal bone metabolism.Cancer cells within bone marrow interfere this balance and cause the change of the corresponding bone metabolism indicators,and this change can be detected through blood or urine.Bone-specific markers researched recently can be summarized as bone resorption markers and bone formation markers,the former include tartrate-resistant acid phosphatase 5b(Tracp5b),carboxy-terminal telopeptide of type Ⅰ collagen (ICTP),N-terminal and C-terminal cross-linked telopeptide of type Ⅰ collagen (NTx/CTx),pyridinoline(PYD) and droxypyridinoline (D-PYD),while the latter consist of bone isoenzyme of alkaline phosphatase(BAP),N-terminal propeptide of type Ⅰ procollagen (PINP),carboxy-terminal propeptide of type Ⅰ procollagen (PICP),bone sialoprotein (BSP),osteocalcin (OC),et al.These laboratory tests can provide more evidences for an early diagnosis of breast cancer with bone metastases.