Study of serum TRACP 5b as a sensitive and specific Bone Resorption Marker of Bone Metastases in Prostate Cancer patients in comparison with Bone Scintigraphy

Skeletal metastases are a most common event in prostate cancer patients with advanced cancer disease. Early detection of bone metastases is crucial to initiate successful therapy. Now a days imaging technique such as bone scintigraphy is a frequently used method for detection of bone metastases. Without radiological tools it is difficult to diagnose, treat or follow clinically, bone metastases patIents. This study was designed to evaluate the utility of bone resorption markers serum tartrate-resistant acid phosphatase 5b (TRACP 5b), serum calcium and commonly used bone formation marker such as serum total alkaline phosphatase (ALP), in comparison with whole body skeletal scintigraphy with Technetium99m MDP, for the diagnosis of bone metastases(BM) in prostate cancer(PC) patients. Four groups of samples were analysed for this study. Group 1(GP 1) consists normal male (cancer free men), Group 2(GP 2) consists PC patients without BM, Group 3(GP 3) consists PC patients with limited BM and Group 4(GP 4) consists PC patients with extensive BM, conformed by whole body skeletal scintigraphy with Technetium99m MDP. One way ANOVA was used to compare serum TRACP 5b, serum ALP and serum calcium among these groups. Serum TRACP 5b is not markedly elevated in limited bone metastases (p = 0.034) but is strongly elevated in extensive bone metastases (P<0.0001). Serum ALP is markedly elevated in both limited and extensive bone metastases (P<0.0001). Serum calcium also shows significant additional background values in bone metastases (P<0.0001).