Levels of Trace Elements in the Affected Area of Bone in The Diagnosis of Osteomyelitis and Osteogenic Sarcoma

Abstract

Purpose: Childhood bone cancer is often difficult to detect in its early stages. One of the most important differential diagnostics is between osteomyelitis (OM) and osteosarcoma (OS). To clarify the possible role of trace elements (TE) as osteosarcoma markers, a nondestructive neutron activation analysis were performed. Material and methods: The Ag, Co, Cr, Fe, Hg, Rb, Sb, Se, and Zn contents were measured in three groups of samples: normal bone samples from 27 persons with intact bone, and also in samples, obtained from open biopsies or after operation of 10 patients with OM and 27 patients with OS. The difference in the results between TE contents in the three groups was evaluated by the parametric Student’s t-test and non-parametric Wilcoxon–Mann–Whitney U-test. Results: In the OS tissue the mean mass fractions of Co, Fe, Se, and Zn are significantly higher (2.6, 2.6, 6.2, and 1.6 times, respectively) and the mean mass fraction of Rb is more than 2 times lower than in the inflamed bone. Different combinations of these TE mass fractions were checked as tumor markers. Conclusion: It was shown that the level of SeZn mass fraction multiplication is the best tumor marker and can be recommended as an additional high informative test for differential diagnosis between OS and a normal or inflamed bone.