Diagnostic Markers of Spinal Metastases of Unknown Origin at Initial Presentation

DOI
  • Maeda Chihiro
    Departments of Orthopaedec Surgery and Musculoskeltal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
  • Hozumi Takahiro
    Departments of Orthopaedec Surgery and Musculoskeltal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
  • Oka Hiroyuki
    Department of Medical Research and Management for Musculoskeltal Pain, 22<sup>nd</sup> Century Medical & Research Center, Faculty of Medicine, The University of Tokyo
  • Yamakawa Kiyofumi
    Departments of Orthopaedec Surgery and Musculoskeltal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
  • Sugita Shurei
    Departments of Orthopaedec Surgery and Musculoskeltal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
  • Fujiwara Masanori
    Departments of Orthopaedec Surgery and Musculoskeltal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
  • Goto Takahiro
    Departments of Orthopaedec Surgery and Musculoskeltal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital

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Other Title
  • 初診時原発不明の転移性脊椎腫瘍に対する原発巣診断に有用な腫瘍マーカー

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Abstract

<p>Introduction: Diagnostic tumor markers for identifying spinal metastases of unknown origin (SMUO) at initial presentation are unknown. Therefore, we aimed to determine the predictive ability of 17 tumor markers for identifying primary sites of spinal metastases.</p><p>Methods: We recruited 240 patients with SMUO at the Komagome Hospital between January 2007 and August 2018. The patients had primary pathologies of the lung (n = 60), prostate (n = 34), breast (n = 15), thyroid (n = 11), pancreatic and bile duct (n = 11), stomach and colon (n = 13), and other digestive organs (n = 33) and all named cancers (n = 184), as well as multiple myeloma (n = 28), malignant lymphoma (n = 18), and others (n = 10). Diagnostic values were statistically determined as areas under the receiver operating characteristics curve (AUCs).</p><p>Results: Significant tumor markers determined using AUCs comprised thyroglobulin (Tg) for thyroid cancer (AUC = 1.0), prostate-specific antigen (PSA) for prostate cancer (AUC = 0.94), carbohydrate antigen 19-9 (CA19-9) and pancreatic cancer-associated antigen for pancreatic and bile duct cancer (AUC = 0.89 and 0.83, respectively), sialyl SSEA-1 antigen (SLX) for lung cancer (AUC = 0.81), CA19-9 for digestive cancer (AUC = 0.74), carbohydrate antigen 153 (CA153) for breast cancer (AUC = 0.73), carcinoembryonic antigen (CEA) for stomach and colon cancer (AUC = 0.73), soluble interleukin 2 receptor (sIL-2R) for malignant lymphoma (AUC = 0.73), and tissue polypeptide antigen/CEA for all named cancers (AUC = 0.72). Serum and urinary values determined using immunoelectrophoresis (IEP) to diagnose multiple myeloma were statistically significant (P < 0.0001, two-tailed test). On the other hand, analysis using sIL-2R is expensive, and CA153 can be substituted by inspection, palpation, and contrast-enhanced computed tomography for detecting breast cancer.</p><p>Conclusions: We recommend analyses using Tg, PSA, CA19-9, SLX, and CEA and IEP to cost-effectively identify primary sites of spinal metastases.</p>

Journal

  • Journal of Spine Research

    Journal of Spine Research 11 (5), 848-852, 2020-05-20

    The Japanese Society for Spine Surgery and Related Research

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