Serum tartrate-resistant acid phosphatase 5b (TRACP 5b) as a marker of skeletal changes in prostate cancer

Salminen, Eeva; Ala‐Houhala, Marja; Korpela, Jukka; Varpula, Matti; Tiitinen, Sari; Halleen, Jussi M.; Väänänen, H. Kalervo

doi:10.1080/02841860500327586

Cited by 18 publications

(9 citation statements)

References 19 publications

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“…Both serum alkaline phosphatase and serum tartrate-resistant acid phosphatase were reported to be able to predict BM from PCa [18,19]. A combination of tartrate-resistant acid phosphatase, alkaline phosphatase and PSA can obviate the need for a bone scan in 70% of cases [20].…”

Section: Discussionmentioning

confidence: 99%

Should Bone Scan be Performed in Chinese Prostate Cancer Patients at the Time of Diagnosis?

Wang

Guo²,

Xu³

et al. 2013

Urol Int

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Background: Prostate cancer (PCa) is increasingly being diagnosed in China. Early detection of bone metastases (BM) is critical in the management of patients with high-risk PCa. The aim of this study is to establish a screening model to determine if bone scan should be performed for BM in Chinese patients at the time when PCa is diagnosed. Materials and Methods: The study included 488 patients who were diagnosed with PCa between 2009 and 2011 at a single center. All patients received bone scans using technetium ^99mTc methylene diphosphonate at the initial staging. If the bone scan finding was equivocal, computed tomography or magnetic resonance imaging was performed to confirm the diagnosis. Age, prostate-specific antigen (PSA) at diagnosis, clinical stage assigned according to the TNM 2002 staging system and biopsy Gleason score were collected in all patients. Multivariate logistic regression analysis was performed to identify statistically significant covariates and then receiver operating characteristic (ROC) curves were generated to identify optimal cut-off values. Using these cut-off values, a formula was devised to calculate an index value for BM screening at diagnosis. The model was cross-validated using the leave-one-out method. Results: Of the 488 patients, 65 patients (13.3%) had BM. The area under the ROC curve was 0.87 (95% confidence interval 0.83-0.94). The sensitivity of the cut-off point was 87.7% and the speciﬁcity was 73.1%. Bone scan is needed for all cT4 PCa patients, however, it is also advisable for cT1-T3 PCa patients who have a biopsy Gleason score ≤3 + 4 and a PSA >132.1, and for cT1-T3 patients having a Gleason score of ≥4 + 3 and PSA >44.5. Conclusions: The regression model may help determine if bone scan is needed to detect BM from PCa at the time of diagnosis. The model was generated upon a single center experience. Further validation is needed in future studies.

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Section: Discussionmentioning

confidence: 99%

Should Bone Scan be Performed in Chinese Prostate Cancer Patients at the Time of Diagnosis?

Wang

Guo²,

Xu³

et al. 2013

Urol Int

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“…Moreover, TRAP has been studied extensively as a serum marker of bone resorption in cancer patients [16][17][18][19]. The serum activity of TRAP can be used to monitor treatment efficiency and recurrence of bone metastasis in breast [20] and prostate [21] cancer patients. These studies indicate that TRAP can be utilized as a marker for progression of metastatic bone disease and suggest that the enzyme could also be a potential target for future cancer therapies.…”

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confidence: 99%

Differential expression of tartrate-resistant acid phosphatase isoforms 5a and 5b by tumor and stromal cells in human metastatic bone disease

Zenger

Ek-Rylander

et al. 2010

Clin Exp Metastasis

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Tartrate-resistant acid phosphatase (TRAP) exists in human serum as two major isoforms, monomeric 5a and proteolytically processed enzymatically active 5b. The 5b isoform is secreted by osteoclasts and has recently been advocated as a serum marker for bone metastasis in breast cancer patients. The 5a isoform, on the other hand, is not bone-derived and has been proposed to be a marker of activated macrophages and chronic inflammation. In this study, expression of TRAP protein and enzymatic activity in bone metastases from different primary sites was examined. TRAP activity was high in bone metastases from prostate cancer, intermediate in breast cancer, and low in lung and kidney cancers. The partially purified TRAP from breast cancer bone metastasis samples exhibited the enzymatic characteristics of purple acid phosphatase. Both 5a and 5b isoforms were expressed in bone metastases of different histogenetic origins, i.e. prostate, breast, lung and kidney, and also a novel previously unreported 42 kDa variant of the TRAP 5a isoform was identified in bone metastases. This novel TRAP 5a isoform was absent in human bone, indicating that the 42 kDa variant is specific to metastatic cancer tissue. Immunohistochemistry revealed that metastatic cancer cells were the predominant source of TRAP 5a, whereas tumor-associated macrophages and occasionally multinucleated giant cells in the tumor stroma preferentially expressed the proteolytically processed TRAP 5b variant. Our results indicate the presence of a previously unstudied variant of monomeric TRAP 5a in cancer cells, which may have functional and diagnostic implications. Moreover, the presence of TRAP-positive macrophages in bone metastases could, together with cancer cells and osteoclasts, contribute to the elevated levels of serum TRAP activity observed in patients with bone metastases.

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“…In this study, the TRACP 5b cutoff was 5.0 U/L, according to a study conducted by Salminen et al [17], who analyzed TRACP 5b as a marker of skeletal changes in patients with prostate cancer using the Bone TRAP Assay.…”

Section: Resultsmentioning

confidence: 99%

“…For TRACP 5b concentrations obtained in our study, we identified the optimal cutoff value at 50.0 U/L in ROC analyses. After applying the cutoff of 50.0 U/L instead of the cutoff 5.0 U/L recommended by Salminen et al [17], the quality parameters of the TRACP 5b analysis changed. Sensitivity decreased to 47.1% from 76.5%; however, the specificity increased considerably to 96.7% from 36.7%.…”

Section: Bone Trap Assaymentioning

confidence: 99%

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2014

Integr Cancer Sci Therap

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The objective of this study was to assess the diagnostic value of the bone resorption marker tartrate-resistant acid phosphatase isoform5b (TRACP 5b) in detecting bone metastases in patients with renal cell carcinoma (RCC). Serum samples of 64 patients with histologically proven RCC were analyzed. Using bone scintigraphy, these patients were divided into 2 groups: 30 patients with RCC without bone metastases and 34 patients with RCC with bone metastases. TRACP 5b concentrations were analyzed in the serum using the Bone TRAP Assay. TRACP 5b concentrations were significantly elevated (p=0.014) in patients with bone metastases (median: 31.9 U/L) compared with patients without bone metastases (median: 8.7 U/L). Elevated TRACP 5b concentrations detected bone metastases with sensitivity of 76.5% and specificity of 36.7%. TRACP 5b appears to be an effective biomarker of bone metastases in patients with RCC.

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Serum tartrate-resistant acid phosphatase 5b (TRACP 5b) as a marker of skeletal changes in prostate cancer

Cited by 18 publications

References 19 publications

Should Bone Scan be Performed in Chinese Prostate Cancer Patients at the Time of Diagnosis?

Should Bone Scan be Performed in Chinese Prostate Cancer Patients at the Time of Diagnosis?

Differential expression of tartrate-resistant acid phosphatase isoforms 5a and 5b by tumor and stromal cells in human metastatic bone disease

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