Elevated N-telopeptide as a potential diagnostic marker for bone metastasis in lung cancer: A meta-analysis

BackgroundGrowing evidence indicates that the cross-linked N-telopeptide of type I collagen (NTx) is likely to be involved in the development of bone metastasis among lung cancer patients. We perform a meta-analysis to disclose the correlation between bone metastasis and NTx and also to evaluate its value in diagnosis of bone metastasis (BM) in lung cancer.MethodElectronic databases were searched and calculated the weighted mean difference (WMD) with 95% confidence interval (CI) to assess the expression difference of NTx between BM+ and BM- lung cancer patients. Moreover, we conducted a sensitivity and specificity test and drew a summary receiver operating characteristic curve (SROC) to assess the diagnostic value of NTx in discerning bone metastasis.ResultsA total of eleven studies with 1108 individuals were included in this analysis. The results showed an increased NTx was correlated with the incidence of lung cancer (P ConclusionsThe elevation of NTx in lung cancer was positively related with the development and progression of bone metastasis. A higher specificity over sensitivity of NTx suggested that it is a more accurate biomarker to distinguish patients without bone metastasis. Regarding SROC curve, sNTx may be a better choice.背景：越来越多的证据表明，I型胶原交联N端肽（cross-linked N-telopeptide of type I collagen，NTx）可能参与肺癌患者骨转移的发生发展过程。本研究开展荟萃分析，旨在阐明肺癌骨转移与NTx之间的相关性，并评估其在肺癌骨转移（BM）诊断中的应用价值。 方法：检索电子数据库，采用加权均数差（WMD）联合95%置信区间（CI），评估骨转移阳性（BM+）与骨转移阴性（BM-）肺癌患者的NTx表达差异；此外，本研究还进行了灵敏度与特异度检验，并绘制汇总受试者工作特征曲线（SROC），以评估NTx鉴别骨转移的诊断价值。 结果：本分析共纳入11项研究，涉及1108名受试者。结果显示，NTx水平升高与肺癌发生率相关。 结论：肺癌患者体内NTx水平升高与骨转移的发生发展呈正相关。NTx的特异度优于灵敏度，提示其作为鉴别无骨转移患者的生物标志物准确性更高。针对汇总受试者工作特征曲线而言，可溶性NTx（soluble NTx，sNTx）或许是更优选择。