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[粒细胞集落刺激因子(G-CSF)和粒细胞-巨噬细胞集落刺激因子(GM-CSF)在Ⅰ、Ⅱ期乳腺癌患者中的血浆水平及诊断效用]

[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].

作者信息

Ławicki Sławomir, Czygier Małgorzata, Wojtukiewicz Marek, Szmitkowski Maciej

机构信息

Zakład Diagnostyki Biochemicznej, Uniwersytetu Medycznego w Białymstoku.

出版信息

Przegl Lek. 2009;66(7):365-9.

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.

摘要

背景

粒细胞集落刺激因子(G-CSF)和粒细胞巨噬细胞集落刺激因子(GM-CSF)属于造血生长因子(HGFs)。很少有临床研究表明它们在体外由人类细胞系以及在体内由肿瘤(例如乳腺癌)自身产生。我们研究了乳腺癌患者治疗前血浆中G-CSF、GM-CSF和常用肿瘤标志物(CA 15-3)的水平,并与健康对照进行比较。此外,还定义了诊断标准:敏感性、特异性、阳性和阴性结果的预测值。

材料与方法

试验组——50例乳腺癌患者,对照组——30名健康女性。采用酶联免疫吸附测定法(ELISA)测定G-CSF和GM-CSF,采用化学发光免疫分析法(CMIA)(雅培公司)测定CA 15-3。

结果

与对照组相比,乳腺癌患者术前II期血浆中G-CSF、GM-CSF和CA 15-3的中位数水平显著更高。G-CSF和GM-CSF的诊断敏感性略低于CA 15-3。在更晚期的乳腺癌阶段观察到受试细胞因子和CA 15-3的诊断敏感性范围更高。联合使用两种细胞因子和CA 15-3分析也导致敏感性范围增加(69%)。受试细胞因子的诊断特异性对于两种细胞因子(均为90%)和CA 15-3(95%)都很高。所有受试参数的阳性和阴性预测值都很高,并且在更晚期肿瘤阶段更高。

结论

本研究表明,受试细胞因子,尤其是G-CSF,在乳腺癌患者的诊断中可能具有临床应用价值,但需要进一步的研究并通过前瞻性研究进行证实。

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