Ławicki Sławomir, Szmitkowski Maciej, Wojtukiewicz Marek
Department of Biochemical Diagnostics, Medical University, Waszyngtona 15A, 15-269 Bialystok, Poland.
Clin Chim Acta. 2006 Sep;371(1-2):112-6. doi: 10.1016/j.cca.2006.02.033. Epub 2006 Apr 21.
In the present study, we investigated the plasma levels of M-CSF and commonly accepted tumor marker (antigen CA 15-3) in breast cancer patients in relation to the group with benign breast tumor and to the healthy controls. Additionally, we compared the plasma level of M-CSF with the tumor stage of breast cancer and defined the diagnostic criteria: sensitivity, specificity, the positive and the negative predictive values. Moreover, we defined the receiver-operating characteristics (ROC) curve for M-CSF and CA 15-3, and correlation between both parameters.
M-CSF and CA 15-3 were measured in 80 patients with breast cancer, 17 patients with benign breast tumor and in 30 healthy subjects. M-CSF was determined using enzyme-linked immunosorbent assay (ELISA). CA 15-3 was measured using a microparticle enzyme immunoassay kit (MEIA).
There were statistically significant differences in the levels of circulating M-CSF and CA 15-3 in the breast cancer patients comparing to the group with benign breast tumor and to the control group. The levels of M-CSF and CA 15-3 were also significantly higher in patients with more advanced tumor stage. Statistically significant positive correlation was observed between the M-CSF and CA 15-3 levels. The M-CSF and CA 15-3 diagnostic specificities were 95%. The diagnostic sensitivity (59%), the positive predictive value (97%) and the negative predictive value (41%) were higher for M-CSF than for CA 15-3 (48.8%, 95% and 40.1%, respectively). The combined use of both cytokines resulted in the increase of the sensitivity to the range of 70%. We observed a higher range of the diagnostic sensitivity of M-CSF in more advanced breast tumor stage. The M-CSF area under the ROC curve was larger (0.801) than the ROC area of CA 15-3 (0.785).
These results suggest that M-CSF is the good candidate for a breast cancer tumor marker.
在本研究中，我们调查了乳腺癌患者血浆中巨噬细胞集落刺激因子（M-CSF）水平以及公认的肿瘤标志物（抗原CA 15-3）水平，并与乳腺良性肿瘤组和健康对照组进行比较。此外，我们比较了M-CSF血浆水平与乳腺癌肿瘤分期，并确定了诊断标准：敏感性、特异性、阳性预测值和阴性预测值。此外，我们绘制了M-CSF和CA 15-3的受试者工作特征（ROC）曲线，并分析了这两个参数之间的相关性。
对80例乳腺癌患者、17例乳腺良性肿瘤患者和30名健康受试者进行M-CSF和CA 15-3检测。采用酶联免疫吸附测定（ELISA）法测定M-CSF。使用微粒酶免疫分析试剂盒（MEIA）测定CA 15-3。
与乳腺良性肿瘤组和对照组相比，乳腺癌患者循环M-CSF和CA 15-3水平存在统计学显著差异。肿瘤分期越晚的患者，M-CSF和CA 15-3水平也显著越高。M-CSF和CA 15-3水平之间存在统计学显著正相关。M-CSF和CA 15-3的诊断特异性均为95%。M-CSF的诊断敏感性（59%）、阳性预测值（97%）和阴性预测值（41%）高于CA 15-3（分别为48.8%、95%和40.1%）。两种细胞因子联合使用可使敏感性提高到70%。我们观察到M-CSF在更晚期乳腺癌肿瘤分期中的诊断敏感性范围更高。M-CSF的ROC曲线下面积（0.801）大于CA 15-3的ROC面积（0.785）。
这些结果表明，M-CSF是乳腺癌肿瘤标志物的良好候选者。
