Value of serum markers in the diagnosis of bone metastasis of breast cancer
Objective To compare the differences of serum albumin-to-alkaline phosphatase ratio(AAPR),alkaline phos-phatase(ALP),ALP/red cell distribution width(RDW),NLR and CA15-3 in breast cancer before and after bone metasta-sis and to explore the clinical values in the diagnosis of bone metastasis of breast cancer patients.Methods Retrospective analysis was performed on the clinical data of 156 newly diagnosed breast cancer patients who were admitted to the Cancer Hospital of the Chinese Academy of Medical Sciences between January 1,2016 and July 31,2018.Patients were divided in-to two groups:those with bone metastases(n=26)and those without(n=130).A control group of 54 healthy people was enrolled throughout the same time period using simple random sampling method.The levels of AAPR,ALP,ALP/RDW,NLR and CA15-3 among three groups were compared.The receiver operating characteristic(ROC)curve was used to as-sess the diagnostic efficacy of individual and combined detection of five markers for breast cancer bone metastases.During the follow-up period,34 patients in the non-bone metastasis breast cancer group developed bone metastases,the five indica-tors of 34 patients were analyzed before and after bone metastases.Results The AAPR of bone metastasis group of breast cancer,non bone metastasis group and healthy control group were 0.47(0.38,0.64),0.72(0.59,0.91),0.75(0.64,0.93),respectively,H=23.076,P＜0.001;The ALP of the three groups were 89.00(70.25,120.18),61.50(50.75,77.25),60.50(48.75,74.25),respectively,H=18.913,P＜0.001;The ALP/RDW of the there groups were 6.65(5.57,9.41),4.76(3.79,6.01),4.56(3.87,5.80),respectively,H=19.343,P＜0.001;The NLR of the there groups were 2.79(1.64,3.85),2.05(1.46,2.92),1.82(1.36,2.21),respectively,H=12.239,P=0.002;The CA1 5-3 of the there groups were 24.04(14.50,124.80),10.07(7.66,15.45),7.08(5.82,10.67),respectively,H=53.486,P＜0.001.When AAPR,ALP,ALP/RDW,NLR and CA15-3 of all participants were used to diagnose bone metastases of breast cancer,the area under ROC curve(AUC)were 0.786,0.761,0.763,0.679 and 0.884,respectively.When five indicators were detected simultaneously,the specificity was 0.743,the sensitivity was 0.962,and the AUC was 0.914.In the patient group without bone metastasis,dynamic detection of five indicators during treatment revealed statistically significant increased in ALP(93.57±53.95),ALP/RDW(7.06±3.73),NLR(2.41±0.97),and CA15-3(58.94±71.12)levels when compared to pre-metastasis,the t values were 3.17,3.19,2.31 and 3.71,and the P values were 0.004,0.003,0.028 and 0.001,respec-tively.Affer bone metastasis,the level of AAPR(0.59±0.24)significantly decreased compared to before(0.73±0.23),t=-3.79,P=0.001.Conlusions The diagnostic value of AAPR,ALP,ALP/RDW,NLR and CA15-3 for breast cancer bone metastases is significant,and the diagnostic effectiveness of combination detection can be increased.
breast cancerbone metastasisalbumin-to-alkaline phosphatase ratioalkaline phosphatase/red cell distribution widthneutrophil-to-lymphocyte ratiocarbohydrate antigen15-3
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