Several different bone markers have been investigated to assist the diagnosis of bone turnover. However the accuracy of those markers does not allow being the only diagnostic instrument to predict the appearance of bone metastasis. So far none of the known markers could be solely used for a screening of patients to diagnose metastasis to bone. The usefulness of bone markers, respectively Alkaline Phosphatase (AP) and Tartrat Resistant Acid Phosphatase 5b (TRACP 5b) for diagnosis, treatment and monitoring of patients with carcinoma of different origin was investigated. Alkaline Phosphatase is a marker of bone formation, while TRACP 5b is a marker of bone resorption. The isoform 5b of the enzyme TRACP is expressed by osteoclasts and can be measured in blood. Objectives: The aim of this study was to evaluate the prognostic value of the bone markers AP and TRACP 5b to detect bone metastasis and pathological bone metabolism. Sera from the patients with tumor markers were collected and the bone markers AP and TRACP 5b were determined. In conclusion TRACP 5b is more sensitive and specific to detect bone metastasis and bone turnover than the Alkaline Phosphatase. In patients with multimorbidity the origin of AP is not clear due to its multiorganic appearance. The levels of TRACP 5b are elevated in patients with bone metastasis and in patients with chronical dysfunction of the liver. TRACP 5b might be helpful in the diagnostic procedure of tumor-patients to detect bone metastasis. Moreover TRACP 5b seems to be helpful to indicate oncological patients with early dysfunctions in bone metabolism and helps to induce early treatment to these patients. (Zulauf N, Speda MD, Oremek GM, Marzi I , Prognostic Value of Bone Markers in Patients with Carcinoma)
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Last date updated on July, 2014