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December 1966

Hydroxyproline Excretion in Malignant Neoplastic Disease

Arch Intern Med. 1966;118(6):565-571. doi:10.1001/archinte.1966.00290180041008

THE HE URINARY excretion of peptide bound hydroxyproline reflects the rate of bone collagen metabolism 1-3 being elevated in disorders affecting bone such as hyperthyroidism,1,3-5 hyperparathyroidism,1,3,6 acromegaly,1,3 Paget's disease of bone,1,3,5,7 Marfan's syndrome,8 Hurler's syndrome,9 malabsorption states (with secondary osteomalacia,7 and rheumatoid arthritis.10 The immediate derivation of urinary hydroxyproline, whether from catabolism of mature bone 2,8 or from synthesis of soluble collagen fractions 2,5,6 or from both is disputed.

Elevated hydroxyproline with normal skeletal radiographs has been reported in pregnancy and postpartum involution,11 psoriasis (with and without arthritis),12,13 thermal burns,14 and mental deficiency states.15,16

Since 1956, hydroxyproline excretion rates have been reported in 80 cases of malignancy with and without bone involvement.5,9,10,17-21 The present communication reports the observations in 117 additional adult patients with malignant neoplastic disease.

Methods  Normal adults and adult patients with cancer in various primary sites and stages were studied. Whenever possible, patients were studied prior to