Serum Bone Metabolic Indicators Tracp5b Diagnosis Of Breast Cancer Bone Metastases And Clinical Studies Of The Nested Pcr Detection Of Breast Cancer Bone Marrow Micrometastases

1. The clinical value of serum Tracp5b as a marker to diagnosebone metastases in breast cancer patients and evaluate thetherapeutic efficacy of bisphosphonateObjective: To compare the diagnostic value of serumTartrate-resistant acid phosphatase 5b(Tracp5b),cancer antigen 153(CA-153) and carcino embryonic antigen (CEA) in patients with bonemetastases of breast cancer, and study the clinical value in evaluating thetherapeutic efficacy of bisphosphonate.Methods: The serum levels of Tracp5b, CA-153 and CEA weredetermined by enzyme-linked immumosorbent assay andelectrochemiluminescence in 26 breast cancer patients without bonemetastases, 32 breast cancer patients with bone metastases and 18 healthyfemale adults. The serum levels of Tracp5b, CA-153 and CEA in 19breast cancer patients with bone metastases after 3 months ofbisphosphonate treatment were also detected.Results: The serum levels of Tracp5b in breast cancer patientswith bone metastases were significantly higher than those in the othertwo groups (P＜0.05). The sensitivity of Tracp5b to bone metastases was78.13% with specificity of 86.36%. The sensitivity and specificity ofCA-153 to bone metastases was 40.63% and 77.27%, and those of CEAwas 21.88% and 84.09%, respectively. The sensitivity of Tracp5b weresignificantly higher than those of CA-153 and CEA(P＜0.05). The serumlevels of Tracp5b decreased significantly after 3 months ofbisphosphonate treatment, while CA-153 and CEA decreased slightly. Conclusions: Tracp5b has a higher sensitivity than CA-153 andCEA to diagnose bone metastases in breast cancer patients. Tracp5b is auseful marker to diagnose bone metastases in breast cancer patients andevaluate the therapeutic efficacy of bisphosphonate.2. The clinical study on detection of CK-19 expression in bonemarrow by nested-RT-PCR in breast cancer patients withmicrometastasesObjective: To explore the feasibility of detection of CK-19expression in bone marrow by nested-RT-PCR in breast cancer(BC)patients with micrometastases.Methods: The breast cancer cells MCF-7 mixed with peripheral bloodmononuclear cells (PBMNC) of healthy donors by different ratio(10^-6～1),and then detected the expression of CK-19 by nested-RT-PCR. The bloodsamples of 30 healthy dondors and 46 bone marrow samples of BC patientswere examined by this method.Results: Detection levels were as high as 1 tumor cell to 10⁶ normalperipheral blood mononuclear cells (PBMNC) by nested-RT-PCR. None ofthe blood sample of 30 healthy dondors was CK-19 positive, while Bonemarrow samples were positive in 18 out of 46(39.1%) patients with breastcarcinomas.Conclusion: Nested-RT-PCR was a sensitive and specific method indetecting micrometastases of breast cancer.