Preliminary report on the diagnostic value of deoxypyridinoline (Dpd) and bone alkaline phosphatase (BAP) in detection of bone metastases in prostatic cancer

We have determined Dpd and BAP for early detection of bone metastases in prostate cancer. The study comprised a group of 30 men with diagnosed and microscopically verified prostate cancer as well as control groups: 17 healthy men and 10 men with BPH. Concentration of Dpd in urine in control group and in the group of men with BPH is higher than the reference range determined by the manufacturer. As a result of the scintigraphic evaluation of bone changes, the group of 30 men with prostate cancer has been divided into three subgroups. Concentration of Dpd in the group of 7 men with scintigraphically verified bone metastases was higher than in the group of 5 subjects with suggested metastatic changes or in the group of 18 men without metastases. The activity of BAP in all groups of studied subjects could be identified within the reference range. In conclusion, determinations of BAP is no use in the early diagnosis of bone metastases in prostate cancer. The wide reference range, suggests that the digital value of Dpd determination repeated in the course of the disease should be considered separately for each patients. In advanced stages of malignant disease metastases into the bones appear in over 25% of all cases. In some neoplasms this percentage is even higher, and in prostatic cancer reaches even 60 to 80%. Neoplasms as breast, estimation of Dpd concentration in urine was performed. Additionally, in all patients, bone scintigraphy and in some x-ray examination were performed. Control group A included 10 men (mean age 64.5 years) in whom prostate benign hyperplasia had been diagnosed and histologically confirmed. Study comprised additional control groups B 17 healthy men, mean age 57.3 years, without any neoplastic disease, who have not got any bone fractures neither in the past nor during this study. In control groups A and B concentration of Dpd in urine as well as BAP activity in serum were estimated. t PSA estimations were performed using Abbott AxSYM analyzer basing on microimmunoenzymatic method (MEIA) applying AxSYM Total PSA tests. Results which didn't exceed 4 ng/ml were considered as normal values. Bone alkaline phosphatase isoform (BAP) was measured with immunoenzymatic method using BAP EIA Kit tests, Metra Biosystems. Normal values for men over 25 year, given by the producer, range from 15.0 to 41.3 U/l. Dpd, was evaluated in second, morning portion of urine, applying immunoenzymatic method using Pyrilinks-D tests, Metra Biosystems. Results were expressed as a ratio to creatinine excretion in the urine. Dpd normal values range for men over 25 years old was determined by the producer as 2.3-5.4 nmol/mmol.