Study of urine Hydroxyproline:creatinine ratio as a bone turnover marker of Bone Metastases along with some routinely used biochemical parameters in patients with Prostate Cancer in comparison with Bone Scintigraphy

Skeletal metastases are a most common event in prostate cancer patients with advanced cancer disease and a significant problem. Now a days imaging techniques such as bone scintigraphy with Technetium 99mMDP (methylene diphosphonate) is a frequently used method for detection of bone metastases. Without the aid of radiological tools it is difficult to diagnose, treat or follow bone metastases cases clinically. This study was designed to evaluate the utility of the bone resorption marker, hydroxyproline: creatinine ratio (OHPr: Cr ratio) in spot urine sample of the patients, along with the estimation of commonly used bone formation marker such as serum total alkaline phosphatase (ALP), serum calcium and serumphosphorous in comparison with whole body skeletal scintigraphy with Technetium99mMDP, for the diagnosis of bone metastases (BM) in prostate cancer (PC) patients. Experimental design: Four groups of samples were analysed. 1st group consist 52 normal males (cancer free men), 2nd group consists 38 PC patients without BM, 3rd group consists 27 PC patients with limited BM (3 or less than 3 skeletal lesions) and 4th group consists 34 PC patients with extensive BM(4 or more than 4 skeletal lesions), confirmed by whole body skeletal scintigraphy with Technetium99m MDP. Results: One way ANOVA was used to compare urine hydroxyproline: creatinine ratio (OHPr: Cr ratio), serum ALP, serum calcium and serum phosphorus among these groups. Both urine OHPr: Cr ratio and serum ALP are strongly elevated in extensive bone metastasescases, thus can be used as a bone turnover marker (P<0.0001). Serum calcium and serum phosphorus will give additional background values.