We investigated the prognostic value of the serum markers of type I collagen synthesis (PINP and PICP) and degradation (ICTP and CrossLaps) in 143 lung cancer patients with a local or locally advanced disease or a metastatic disease. The mean values of ICTP, CrossLaps, PINP and PICP were significantly higher in patients with bone metastases than in those without metastases or with only soft tissue metastases. The patients with ICTP