Prognostic value of PINP, bone alkaline phosphatase, CTX‐I, and YKL‐40 in patients with metastatic prostate carcinoma

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Abstract
BACKGROUND: To examine the prognostic value of markers of bone metabolism (serum PINP, BAP, and CTX‐I) and serum YKL‐40 in metastatic prostate carcinoma (PC).METHODS: The biomarkers were determined by ELISAs in 153 metastatic PC patients before treatment with parenteral estrogen or total androgen ablation. The median follow‐up was 4.9 years. One hundred fifteen patients died.RESULTS: The biomarkers were increased in the patients compared to controls (P < 0.001), and related to performance status and Soloway score (except YKL‐40), but not to T‐category and WHO tumor grade. PINP was elevated in 87%, BAP (55%), CTX‐I (33%), and YKL‐40 (43%). Univariate analysis showed an association to survival: PINP (HR = 1.6, P < 0.0001), BAP (HR = 1.4, P < 0.0001), CTX‐I (HR = 1.7, P < 0.0001), and YKL‐40 (HR = 1.4, P = 0.004). In multivariate Cox analysis performance status, WHO grade, Soloway score, PINP, and YKL‐40 were independently predictive factors.CONCLUSIONS: High serum PINP, BAP, CTX‐I, and YKL‐40 are associated with poor outcome of metastatic PC patients. Prostate