Summary
Biomarkers as biochemical substances of collagen metabolism are produced during bone turnover and can be determined as parameters of bone metabolism not only in serum, but also in urine. These growth and decomposition products of the bone are already used to determine bone metabolism in osteoporosis and to prove efficacy of antiresorptive therapy. Metastases of the bone likewise show a higher rate of bone turnover. Nowadays detection of neoplastic bone lesions and progression of their spread are performed with x-rays, radionucleoide bone imaging and magnetic resonance imaging. In the future, biomarkers might improve early detection of bone lesions and follow-up of skeletal metastases. At present, the clinical use is documented insufficiently. In the foreseeable future the determination of the bone turnover markers and additional serum parameters of bone metabolism such as OPG, RANKL might be available for early diagnosis and follow-up in patients with bone metastatic diseases.
Zusammenfassung
Biomarker, als biochemische Substanzen des Kollagenstoffwechsels, fallen beim Knochenumbau an und können als Parameter des Knochenmetabolismus sowohl im Serum, als auch im Harn bestimmt werden. Diese An- und Abbauprodukte des Knochens werden bereits zur Bestimmung der Knochenformation und -resorption bei der Osteoporose genutzt. Knochenmetastasen weisen ebenfalls einen erhöhten Knochenumbau auf. Bisher werden die ossäre Metastasierung und der Progress der Ausbreitung maligner Zellen in den Knochen lediglich mit bildgebenden Verfahren, wie konventionellem Röntgen, Knochenszintigraphie oder Magnetresonanztomographie, in einem fortgeschrittenen Stadium der Erkrankung diagnostiziert. Biomarker könnten zukünftig frühzeitig, kostengünstig Skelettmetastasen, deren Verlauf und deren Ansprechen auf Therapiemaßnahmen erfassen. Derzeit ist der klinische Nutzen noch unzureichend dokumentiert und die Bestimmung ineffizient. Durch die Optimierung der Bestimmung von Knochenumbaumarkern und zusätzlichen neuen Serumparametern des Knochenmetabolismus, wie OPG, RANKL, könnten in absehbarer Zeit neue diagnostische und prognostische Möglichkeiten zur Verfügung stehen.
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Beke, D., Kudlacek, S. & Meran, J. Klinische Relevanz von Biomarkern bei der Skelettmetastasierung von Malignomen. Wien Med Wochenschr 157, 375–380 (2007). https://doi.org/10.1007/s10354-007-0422-x
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DOI: https://doi.org/10.1007/s10354-007-0422-x