Evaulation of the role of bone metabolic markers in clinical management of bone metastasis of lung cancer

Sixty five lung and pleural cancer patients who have been followed at Adnan Menderes University Chest Department between 2007 and 2008 were included into this trial. The aim of the study was to evaluate the role of bone metabolic markers in managing bone metastasis of lung cancer. All patients were male and mean age was 64±8.7 (43-80). The presence of bone metastasis was invastigated by whole body bone scintigraphy via Tc 99m mostly, but in some cases, pozitron emission tomography and computerized tomography were used.Non small cell lung cancer patients were 76,9% of the whole group and 20% of the cases were small cell lung cancer. The great majority of the distant metastasis were to bones. There were 23 cases who had bone metastasis. Single bone metastasis was detected in three of the patients and 20 of the cases had multiple bone metastasis. All cases were divided into two groups according to presence or absence of bone metastasis. Bone spesific alkaline phosphatase and osteocalcin were measured in serum as production markers of bone. N terminal telopeptide (NTX) and ß-C terminal telopeptide were studied as bone destruction markers. The statistical analyses were performed with SPSS 10.0 program. Serum levels of total alkaline phosphatase, bone spesific alkaline phosphatase and NTX were significantly higher in the group with bone metastasis (p<0,05). But serum osteocalcin and ß-C terminal telopeptide levels were not significantly different between two groups. At the threshold value of 22,38 µg/L, the sensitivity of bone spesific ALP was 60,87% and the specifity of this marker was 69,05%. Similarly, at the threshold value of 25,69 nmol BCE, the sensitivity of NTX was 90,24% and the specifity was 43,4Bone metabolic markers are noninvasive, usable and cost effective tools for evaluation of bone metastasis in lung cancer. But, more studies are needed to use them in daily practice for bone metastasis.Key Words: Lung cancer, bone marker, bone metastasis.