【摘要】 目的　探讨骨特异性碱性磷酸酶 (BALP)、Ⅰ型胶原羧基端前肽 (CICP)、骨钙素 (BGP)等成骨标志物和抗酒石酸酸性磷酸酶 (TRAP)、脱氧吡啶酚 (Dpd)等破骨标志物与骨肉瘤术后化疗疗效之间的关系。 方法　采用现代免疫学技术检测 2 5例骨肉瘤患者在化疗前及每次化疗后的各项指标。结果　骨肉瘤患者的BALP(X)与血碱性磷酸酶 (Y)之间具有显著的线性相关性 (Y =6 .10 0± 2 .377X ,P <0 .0 1)。肿瘤坏死率 <90 %患者的BALP在术前化疗前后均表现为高水平 ,坏死率≥ 90 %患者的Dpd在术前化疗后明显下降。术后出现复发转移患者的Dpd在术后第 2次化疗后有一突跳升高 ;BALP与CICP在复发、转移前突然增高。 结论　术前骨肉瘤患者BALP与Dpd的变化趋势可能与肿瘤坏死率有关 ;术后化疗初始阶段Dpd的升高可能提示化疗疗效不佳 ;而术后BALP、CICP的突然增高可能预示着复发或转移。因此 ,成骨与破骨标志物同骨肉瘤术后化疗有效性之间可能存在某些关联。更多还原

【Abstract】 Objective The purpose of this research was to explore the relationship between the bone formation markers such as bone alkaline phosphatase(BALP), collagen type I C-terminal propeptide(CICP), bone Gla-protein(BGP), as well as the bone resorption markers including tartrate-resistant acid phosphatase(TRAP),deoxypyridinoline (Dpd) and effectiveness of postoperative chemotherapy of osteosarcoma. Methods Twenty-five osteosarcoma patients were tested for these markers in blood and urine before and after each chemotherapy trial with immunologic techniques.Results There was obvious linear relevancy between BALP and blood alkaline phosphatase(P<0.01). For the cases whose tumor necrosis rate <90%, BALP always expressed in high level before and after preoperative chemotherapy, while for those tumor necrosis rate ≥90%, Dpd expressed apparently lower after preoperative chemotherapy. For those suffering recurrent or metastasis postoperatively, Dpd elevated abruptly after the second postoperative chemotherapy, and both BALP with CICP increased sharply when recurrent or metastasis occurred.Conclusions The variation of BALP and Dpd in osteosarcoma patients preoperatively may be linked with tumor necrosis rate which could assess the response to preoperative chemotherapy. The elevation of Dpd at the initial stage of postoperative chemotherapy may predict presence of poor response. Furthermore, the high expressions of BALP and CICP may indicate recurrent or metastasis of osteosarcoma. Certain relationships may exist between the bone formation and resorption markers and the effectiveness of postoperative chemotherapy for osteosarcoma.更多还原