摘要
Abstract
Objective:To study the predictive value of serum alkaline phosphatase(ALP),calcium(Ca2+)and D-Dimer concentrations in bone metastasis of breast cancer.Methods:A retrospective analysis was conducted on 111 breast cancer patients admitted to The First Affiliated Hospital of Bengbu Medical University from July to December in 2022.According to the results of ECT bone scan and MRI examination,they were divided into a non-bone metastasis group(63 cases),a limited bone metastasis(bone metastases≤5,15 cases)and an extensive bone metastases group(bone metastases＞5,33 cases).One-way analysis of variance,Spearman correlation analysis and ROC curve were used to analyze the predictive value of each index on bone metastasis of breast cancer.Results:The differences in ALP and D-Dimer among the three groups of patients were statistically significant(P＜0.05).But the difference in Ca2+concentration was not statistically significant(P＞0.05).Further pairwise comparison results showed that the ALP concentration in extensive bone metastases group was significantly higher than that in non-bone metastasis group(P＜0.05).The D-Dimer concentration in limited bone metastasis group and extensive bone metastases group was significantly higher than that in non-bone metastasis group(P＜0.05).There was no statistically significant difference in ALP concentration between non-bone metastasis group and limited bone metastasis group.There was also no significant difference in ALP and D-Dimer concentrations between limited bone metastasis group and extensive bone metastases group(P＞0.05).Spearman test results showed that ALP(r=0.294,P=0.001)and D-Dimer concentrations(r=0.593,P＜0.001)were positively correlated with the severity of bone metastasis,while Ca2+concentration had no correlation with the severity of bone metastasis(r=0.012,P=0.902).The area under ROC curve(AUC)of ALP and D-Dimer concentrations for diagnosis of bone metastasis of breast cancer was 0.653(95% CI:0.549-0.757)and 0.841(95% CI:0.753-0.929)respectively.The optimal cutoff values were 73.500 U·L-1 and 0.635 mg·L-1,the sensitivities were 58.333% and 77.083%,and the specificities were 72.718% and 93.939% respectively.The combined prediction of bone metastasis had the highest AUC of 0.847(95% CI:0.764-0.930),with a sensitivity of 77.083% and a specificity of 95.385% .According to the results of the analysis of variance,the combined use of ALP and D-Dimer for diagnosing breast cancer bone metastases had higher sensitivity and is more effective in identifying cases of bone metastases.In terms of specificity,the combined approach did not show a significant advantage over D-Dimer alone,D-Dimer had a higher Youden's index.Conclusion:The concentrations of serum ALP and D-Dimer have certain predictive value for predicting bone metastasis of breast cancer.As bone markers,ALP and D-Dimer concentrations are correlated with bone metastasis of breast cancer.D-Dimer can be considered as the only prediction index to be selected.The concentration of Ca2+is not correlated with bone metastasis of breast cancer.关键词
乳腺癌/骨转移瘤/碱性磷酸酶/钙离子/D-二聚体Key words
Breast cancer/Bone metastases/Alkaline phosphatase/Calcium/D-Dimer分类
医药卫生
