Abstract
Turnover of collagen in the body, 50% of which occurs in bone, results in the excretion of substantial amounts of hydroxyproline in the urine. Urinary hydroxyproline excretion and, in particular, the hydroxyproline/creatine ratio increase in the presence of primary and secondary neoplasms of bone. There is a good correlation between elevated urinary hydroxyproline excretion and metastases to bone from breast cancer. Moreover, in “early” breast cancer without demonstrable metastases we have found a good correlation between elevated levels of hydroxyproline in urine and axillary lymph node metastases at operation, subsequent development of bone metastases, and survival. In patients with disseminated disease undergoing hormone manipulation therapy, we have observed that urinary hydroxyproline excretion correlates with the response to treatment. Measurement of urinary hydroxyproline excretion appears to be a useful tool in staging breast cancer and monitoring the activity of the disease.
Résumé
Le turnover de collagène, dont la moitié a lieu dans le squelette, aboutit à l'excrétion d'importantes quantités d'hydroxyproline dans les urines. L'excrétion d'hydroxyproline urinaire et, en particulier, le rapport hydroxyproline/créatine sont accrus dans les néoplasmes osseux primitifs et en cas de métastases osseuses. Il existe une bonne corrélation entre l'élévation du débit urinaire d'hydroxyproline et la présence de métastases osseuses d'un cancer du sein. De plus, dans les cancers mammaires “débutants” sans métastase démontrable, nous avons trouvé une bonne corrélation entre les taux élevés d'hydroxyproline dans l'urine, la présence de métastases ganglionnaires axillaires à l'opération, l'apparition ultérieure de métastases osseuses et la survie. Chez les patients soumis à une hormonothérapie pour généralisation de la maladie, nous avons observé que le débit urinaire d'hydroxyproline varie en fonction de la réponse au traitement. La mesure de l'excrétion urinaire d'hydroxyproline est un test utile pour déterminer le stade du cancer du sein et l'activité de la maladie.
Similar content being viewed by others
References
Hioco, D., Guson, M., Ryckewaert, A., DeSeze, S.: IntérÊt et signification de l'hydroxyproline urinare dans les maladies osseuses. Sem. HÔp. Paris42:2497, 1966
Platt, W.D., Doolittle, L.H., Hartshorn, J.: Urinary hydroxyproline excretion in metastic cancer of bone. N. Engl. J. Med.271:287, 1964
Leroy, E.C., Carbone, P.P., Sjoerdsma, A.: Elevated plasma levels of a hydroxyproline containing protein in Hodgkin's disease and their relation to disease activity. J. Lab. Clin. Med.67:891, 1966
Bonadonna, G., Merlino, M.J., Laird Myers, W.P., Sonenberg, M.: Urinary hydroxyproline and calcium metabolism in patients with cancer. N. Engl. J. Med.270:298, 1966
Hosley, H.F., Taft, E.G., Olson, D.B., Gates, S., Beebe, R.: Hydroxyproline excretion in malignant neoplastic disease. Arch. Intern. Med.118:565, 1966
Cuschieri, A., Feigate, R.A.: Urinary hydroxyproline excretion in carcinoma of the breast. Br. J. Exp. Path.53:237, 1972
Guzzo, C.E., Pachas, W.N., Pinals, R.S., Krant, M.J.: Urinary hydroxyproline excretion in patients with cancer. Cancer24:382, 1969
Cuschieri, A.: Urinary hydroxyproline excretion in early and advanced breast cancer—a sequential study. Br. J. Surg.60:800, 1973
Sumner, D.S., Baum, M., Parsons, V., Edwards, M.H.: Early breast cancer, bone scanning and the urinary excretion of hydroxyproline. Communication to Surgical Research Society, London, 1973
Roberts, J.G., Williams, M., Henk, J.M., Bligh, A.S., Baum, M.: The hypronosticon test in breast cancer. Clin. Oncol.1:33, 1975
Powles, T.J., Leese, C.L., Bondy, P.K.: Hydroxyproline excretion in patients with breast cancer and response to treatment. Br. Med. J.2:164, 1975
Cuschieri, A.: Urinary hydroxyproline excretion and survival in cancer of the breast. Clin. Oncol.1:127, 1975
Prockop, D., Sjoierdsma, A.: Significance of urinary hydroxyproline in man. J. Clin. Invest.40:843, 1961
Jasin, H.E., Fink, C.W., Wise, W., Ziff, M.: Relationship between urinary hydroxyproline and growth. J. Clin. Invest.41:1928, 1962
Smith, R., Dehan, M., Reynolds, E.O.R.: Changes in urinary hydroxyproline in premature infants. Clin. Chim. Acta21:491, 1968
Klein, L., Yen, S.S.C.: Urinary peptide hydroxy-proline before and during postpartum involution of the uterus. Metabolism19:9, 1970
Goidanich, I.F., Lenzi, L., Silva, E.: Urinary hydroxyproline excretion in normal subjects and in patients affected with primary diseases of bone. Clin. Chim. Acta11:3, 1965
Anderson, J., Bannister, D.W., Parsons, V., Tomlinson, R.W.S.: Total urinary hydroxyproline excretion in osteomalatia. Calcif. Tissue Res.1:183, 1967
Hartmann, F., Rohde, J., Schmit, A.: Aktivitätsdiagnostik bei der primär—chronischen polyarthritis. Z. Rheumaforsch.28:263, 1969
Citrin, D.L., Cuschieri, A., Furnival, C., Blumgart, L.H.: A comparison of the99mTc phosphate bone scan and urinary hydroxyproline excretion in the diagnosis of skeletal metastases. Clin. Oncol.1:174, 1975
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cuschieri, A. Urinary hydroxyproline in the management of breast cancer. World J. Surg. 1, 299–302 (1977). https://doi.org/10.1007/BF01556842
Issue Date:
DOI: https://doi.org/10.1007/BF01556842