Evaluation of the clinical value of bone metabolic parameters for the screening of osseous metastases compared to bone scintigraphy

88 patients aged 21 – 82 years with malignant tumors were prospectively studied. The serum concentrations of PINP and ICTP were measured and compared to the results of bone scintigraphy, radiological bone series, CT, MRI and clinical follow-up.Osseous metastases were found in 21 patients. 19 of them were correctly identified by bone scintigraphy (sensitivity: 90%). For bone metabolic markers results were as follows: ICTP sensitivity: 71%, specificity: 42%; PINP sensitivity: 24%, specificity: 96%.As markers of bone metabolism PINP and ICTP showed low sensitivity and/or specificity for the detection of osseous metastases. The presented markers did not seem to be sufficient enough to identify patients with bone metastases or to replace established screening methods.Bone metastases are common in advanced cancers of the lung, breast, kidney, prostate and others. In autopsy studies the prevalence ranges from 47–85% [1]. In patients with osseous metastases early detection is needed, since without effective treatment these bone metastases can cause severe complications leading to considerable morbidity and reduced quality of life.The screening for bone metastases is usually based on bone scintigraphy, confirmed by supplemental radiographic bone surveys, computer tomography, or magnetic resonance imaging. Bone scans are simple to perform and examine the whole skeleton, but although the sensitivity of this method is high its specificity is poor. For this reason, in many cases a positive scan requires confirmation by other imaging modalities, which leads to higher costs and time-consuming investigations. Therefore, an alternative cost-effective screening method with a similar sensitivity and a higher specificity would be very welcome.For the formation of osseous metastases the extracellular matrix consisting of collagens combined with noncollagenous glycoproteins and proteoglycans, including the basement membrane and the interstitial stroma play an important role. Normally, th