medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-7-120-132medsovet-6146Research ArticleДРУГИЕ ПРОБЛЕМЫ ЭНДОКРИНОЛОГИИOTHER PROBLEMS OF ENDOCRINOLOGYМаркеры костного ремоделирования и их значение при онкологических заболеванияхBone remodeling markers and their role in oncologyhttps://orcid.org/0000-0003-2320-1051ГолоунинаО. О.GolouninaO. O.

Голоунина Ольга Олеговна - студент 4-го курса Центра инновационных образовательных программ «Международная школа «Медицина будущего».

119991, Москва, ул. Трубецкая, д. 8, стр. 2.

SPIN-код: 7793-2123

Olga O. Golounina - 4-year Medical Student, International School «Medicine of the Future» Center for Innovative Educational Programs Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991.

olga.golounina@mail.ruhttps://orcid.org/0000-0002-6674-6441БелаяЖ. Е.BelayaZh. E.

Белая Жанна Евгеньевна – доктор медицинских наук, заведующая отделением нейроэндокринологии и остеопатий, профессор кафедры эндокринологии Института высшего и дополнительного профессионального образования.

117036, Москва, ул. Дмитрия Ульянова, д. 11.

SPIN-код: 4746-7173

Zhanna E. Belaya - Dr. Sci. (Med.), Head of the Department of Neuroendocrinology and Bone Disease, Professor of Department of Endocrinology, Institute of Further Professional Education, National Medical Research Center for Endocrinology.

11, Dmitry Ulyanov St., Moscow, 117036.

jannabelaya@gmail.comПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationНациональный медицинский исследовательский центр эндокринологииРоссияNational Medical Research Center for EndocrinologyRussian Federation20211205202107120132Copyright © Голоунина О.О., Белая Ж.Е., 20212021Голоунина О.О., Белая Ж.Е.Golounina O.O., Belaya Z.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6146

Метастатическое поражение скелета - часто возникающее осложнение онкологических заболеваний. Костные метастазы существенно влияют на выживаемость, качество жизни и состояние больных, увеличивая риск развития скелетных событий, включающих гиперкальциемию, патологические переломы костей, болевой синдром различной интенсивности, компрессию спинного мозга. Современные инструментальные методы исследования выявления костных метастазов имеют некоторые ограничения, такие как высокая стоимость и ограниченная доступность в локальных онкологических учреждениях, а также определенный процент сомнительных результатов. В этом аспекте поиск дополнительных неинвазивных чувствительных маркеров костного метаболизма, отражающих интенсивность процессов резорбции и костеобразования, представляет теоретический и практический интерес. Маркеры костного ремоделирования (N-концевой пропептид коллагена 1-го типа, остеокальцин, С-концевой телопептид коллагена 1-го типа и др.) достаточно давно используются для прогнозирования эффективности патогенетической терапии остеопороза, как дополнительный фактор риска при принятии решения о начале терапии остеопороза, в диагностическом поиске при вторичных формах остеопороза, а также как предикторы переломов в популяционных исследованиях. Целью настоящего обзора стало обобщение имеющейся информации и доказательств эффективности использования маркеров костного ремоделирования у онкологических больных. Представлены современные исследования по возможностям применения костных маркеров в диагностике и прогнозе риска развития метастазов в кости и скелетных осложнений, прогнозировании клинических исходов прогрессирования заболевания и выживаемости пациентов. Показано, что снижение или нормализация биохимических маркеров костного ремоделирования на фоне терапии бисфосфонатами ассоциирована с улучшением выживаемости и снижением риска осложнений со стороны скелета у пациентов с метастазами в кости. Новые данные могут стать рациональной основой для более широкого использования маркеров костного метаболизма в онкологической практике. Однако необходима стандартизация и валидизация определения биохимических маркеров костного метаболизма и верификация отрезных диагностических точек для их внедрения в рутинную клиническую практику обследования онкологических больных.

Bone metastases are a common complication of cancer. Patients with bone metastases may have experienced skeletal-related events, such as hypercalcemia, pathological fractures, pain syndrome of varying intensity, spinal cord compression with negative effects on the quality of life. Current diagnostic tools have some limitations, such as high cost and limited availability in the distant areas, as well as falls negative and falls positive results. In this aspect, non-invasive sensitive markers of bone metabolism might give additional valuable information. Bone remodeling markers (N-terminal propeptide of type 1 collagen, osteocalcin, C-terminal telopeptide of type 1 collagen, etc.) have been used for a long time to predict the effectiveness of osteoporosis treatment; as additional risk factors for treatment initiation in patients with osteoporosis, in diagnostic search for secondary forms of osteoporosis; and as predictors of fracture in population studies. This review summarizes the clinically relevant biochemical markers of bone remodeling and the available evidence for their use in the metastatic bone disease in particularly in the diagnosis and prognosis of bone metastases risk and skeletal complications, predicting clinical outcomes, bone disease progression and overall survival. It has been shown that a sufficient suppression of bone remodeling biochemical markers while on treatment with bisphosphonates is associated with an improvement in survival and a decrease in the risk of skeletal complications in patients with bone metastases. New data may become a rational basis for wider use of bone metabolism markers in oncological practice. However, it is necessary to standardize and validate the determination of bone markers and verification of cut-off diagnostic values for their introduction into the routine clinical practice of patients with malignancy.

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The authors declare that there are no conflicts of interest present.