[The plasma levels and diagnostic utility of granulocyte-colony stimulating factor (G-CSF) and granulocyte-macrophage - colony stimulating factor (GM-CSF) in patients with I and II stage of breast cancer]

Abstract

Background: Granulocyte-colony stimulating factor (G-CSF) and granulocyte-macrophage - colony stimulating factor (GM-CSF) belong to hematopoetic growth factors (HGFs). Few clinical investigation have shown their autologous production both in vitro by human cell lines and in vivo by tumors, for example in breast cancer. We have investigated the plasma levels of G-CSF, GM-CSF and commonly accepted tumor marker (CA 15-3) before treatment of breast cancer patients in relation to the healthy controls. Additionally, the diagnostic criteria: sensitivity, specificity, the predictive value of positive and negative results were defined.

Material and methods: Tested group--50 patients with breast cancer, control group--30 healthy women. G-CSF and GM-CSF were determined using ELISA method, CA 15-3--was measured by chemilumunescence immunoassay (CMIA) (ABBOTT).

Results: Median values of G-CSF, GM-CSF and CA 15-3 plasma levels were significantly higher in the II stage of breast cancer patients before surgery compared to the control group. The diagnostic sensitivity of G-CSF and GM-CSF was slightly lower than CA 15-3. The higher range of the diagnostic sensitivity of tested cytokines and CA 15-3 in more advanced breast stages was observed. The combined use of both cytokines and CA 15-3 analysis resulted also in the increased sensitivity range (69%). The diagnostic specificities of tested cytokines were high for both cytokines (equal 90%) and CA 15-3 (95%). The positive and negative predictive values were high for all tested parameters and were higher in more advanced tumor stage.

Conclusions: This study suggests that tested cytokines, especially G-CSF, can be clinically useful in diagnostics of breast cancer patients, but further investigation and confirmation by a prospective study are necessary.