| Objective:Primary lung cancer is an extremely malignancy in the worldwide scale,and one of the most common disorder of respiratory medicine,the greatest increase in mortality rate of primary lung cancer has occurred in countries.Lung cancer patients with bone metastasis have a great risk of bone-related events,which affects the quality of life and overall survival seriously.Alkaline phosphatase is a group of orthophosphoric ester monohydrolase,and has high specificity and sensitivity in the diagnosis of bone metastasis.Data from many studies indicated that bone sialoprotein mainly involved in the processes of tumor cell adhesion,anti-apoptosis,angiogenesis and bone destruction,it evevated that the level of BSP in primary tumor tissues is obviously high in lung cancer patients with bone metastasis,but few studies demonstrated the relationship of serum BSP levels and lung cancer with bone metastasis.On the basis of previous researches,we detected the levels of serum BSP and ALP in lung cancer paients with bone metastasis,and studied the value of early diagnosis of them in bone metastasis further,expected to screen the groups who at high risk of bone metastasis through a quick and easy way.Methods:A total of 54 patients with primary lung cancer diagnosed by pathology from Department of Respiratory Medicine,the First Afflliated Hospital of Wannan Medical College from July 1st 2014 to November 30 st 2015 were included,in which 33patients were diagnosed with bone metastasis,the treatments to them were used by NCCN guidelines recommend first-line chemotherapy and according to the patient's own conditions by palliative chemotherapy,21 cases of healthy people were also collected in the same period.We detected the levels of serum BSP and ALP,followed up and made a retrospective analysis of the factors which may affect the survival and prognosis.The follow-up started on the diagnosis day of lung cancer or bone metastasis and ended on November 30 st 2015 by outpatient,telephone etc.To patient death,loss of follow-up visit or last time for end.All clinical and pathological datas recorded in this study included age,gender,histological type,tumor size,smoking history,PS score and so on.Results:The levels of serum BSP among the healthy group,lung cancer without bone metastasis group,lung cancer with bone metastasis group had significant difference(P<0.01),by single factor analysis of variance.Between each of the two groups comparison,the result had statistically significant difference.The levels of serum ALP among the three groups also had significant difference(P<0.01),the difference between the healthy group and the lung cancer without bone metastasis group had no statistical significance(P>0.05),the difference between the healthy group with the other two groups both had statistical significance(P<0.01).There was no statistical significance among the three groups in age,gender and smoking history.The difference was statistically significant between the groups with bone metastasis and without bone metastasis in tumor diameter(P<0.01),and the critical tumor diameter was defined as 3cm.The median survival of lung cancer patients with bone metastasis is shorter than that without bone metastasis,which was 6.9 months and 12.5 months,respectively.Conclusions:The level of serum ALP and BSP has obvious relevance with bone metastasis,they may be used as an indicator of early bone metastasis of lung cancer patients and screen out the high-risk crowds.The higher it is,the worse prognosis the ptients will have,they can serve as a marker to asses the survival of patients with lung cancer probably.Tumor diameter>3cm could become an independent risk factor for bone metastasis.But it still require further researches of large samples study. |
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