@Article{096504016X14768398678750,
AUTHOR = {Gamal A. Elfar, Mohamed A. Ebrahim, Nehal M. Elsherbiny, Laila A. Eissa},
TITLE = {Validity of Osteoprotegerin and Receptor Activator of NF-κB Ligand for the  Detection of Bone Metastasis in Breast Cancer},
JOURNAL = {Oncology Research},
VOLUME = {25},
YEAR = {2017},
NUMBER = {4},
PAGES = {641--650},
URL = {http://www.techscience.com/or/v25n4/56845},
ISSN = {1555-3906},
ABSTRACT = {Osteoprotegerin (OPG) is a robust antiresorptive molecule that acts as a decoy receptor for the receptor activator of nuclear factor kB ligand (RANKL), the mediator of osteoclastogenesis. This study was designed to 
explore the possible role of serum OPG and RANKL in detecting bone metastasis in breast cancer and its interaction with clinicopathologic parameters. Serum levels of RANKL and OPG were estimated in 44 metastatic 
and 36 nonmetastatic breast cancer patients using ELISA kits. Serum OPG levels were significantly reduced in 
patients with bone metastasis and correlated negatively with the number of bone lesions and CA 15-3 levels. 
At concentrations ≤82 pg/ml, OPG showed a high specificity in identifying the presence of bone metastasis 
(92%), albeit with low sensitivity (59%), which improved after the exclusion of diabetics and patients treated 
with aromatase inhibitors (AI). Serum RANKL levels were significantly higher in the presence of bone metastasis and hypercalcemia. At concentrations >12.5 pg/ml, RANKL had an associated sensitivity of 86%, albeit 
with low specificity (53%), in detecting bone metastasis. The RANKL/OPG ratio significantly increased in the 
presence of bone metastasis with appropriate sensitivity and specificity (73% and 72%, respectively) at a cutoff 
of ≥0.14 for the detection of bone metastasis. Serum OPG and RANKL/OPG ratios are promising biomarkers 
for detecting bone metastasis in breast cancer patients.},
DOI = {10.3727/096504016X14768398678750}
}