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Bone and total alkaline phosphatase for screening skeletal metastasis in patients with solid tumours
Author(s) -
SCHINDLER F.,
LAJOLO P.P.,
PINCZOWSKI H.,
FONSECA F.L.A.,
BARBIERI A.,
MASSONETTO L.H.,
KATTO F.T.,
Del GIGLIO A.
Publication year - 2008
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/j.1365-2354.2007.00826.x
Subject(s) - medicine , alkaline phosphatase , metastasis , bone metastasis , prospective cohort study , cancer , elevated alkaline phosphatase , gastroenterology , pathology , enzyme , biochemistry , chemistry
Alkaline phosphatase (AP) has several isoforms including bone alkaline phosphatase (BAP). We evaluated BAP and AP for screening for bone metastasis (BM) in patients with solid tumours. This is a prospective non‐blinded study conducted at ABC Foundation School of Medicine Oncology clinics. A total of 40 subjects without a history of cancer and 62 patients with various solid tumours referred for a bone scan had serum drawn for BAP and AP determination. Bone alkaline phosphatase and AP levels in patients with cancer and BM, without BM and with no cancer, were 70.32 ± 3.65 and 310.21 ± 16.87 U/L; 41.40 ± 2.80 and 113.23 ± 12.95 U/L; 21.19 ± 2.76 and 148.05 ± 12.79 U/L respectively ( P < 0.0001 for both AP and BAP). For BAP and AP sensitivity, specificity, positive and negative predictive values were 0.86 and 0.52; 0.69 and 1; 0.45 and 1; 0.94 and 0.87 respectively. ROC AUC value for BAP was 0.89 and for AP was 0.93. We conclude that BAP is more sensitive than AP, whereas AP had a remarkable specificity of 100%. In screening for BM in patients with solid tumours, obtaining initially BAP and then selecting for further investigation only patients with an abnormal AP may be a cost and resource saving strategy.