Ławicki Sławomir, Zajkowska Monika, Głażewska Edyta K., Będkowska Grażyna E., Szmitkowski Maciej
Clin Lab. 2016 Sep 1;62(9):1661-1669. doi: 10.7754/Clin.Lab.2016.160118.
M-CSF, MMP-2 and its inhibitor TIMP-2 may play a role in the pathogenesis and proliferation of breast cancer (BC). In this paper, plasma levels and the diagnostic utility of these parameters were investigated in comparison to CA 15-3 in patients with BC and in relation to the control groups: patients with benign breast tumor and healthy subjects.
Plasma levels of the tested parameters were determined using immunoenzyme assay (ELISA) and CA 15-3 with a chemiluminescence method (CMIA).
Our results demonstrated significant differences in the concentration of the tested parameters and CA 15-3 between BC patients and healthy subjects or benign breast tumor patients. Only the plasma levels of TIMP-2 were significantly higher at all tumor stages (I - IV) when compared to healthy controls. M-CSF and TIMP-2 values were comparable to CA 15-3 values for the diagnostic sensitivity, specificity, the predictive values of positive and negative test results (PPV, NPV) and the area under the ROC curve (AUC) in the total BC group. The combined use of the tested parameters with CA 15-3 resulted in the increase in sensitivity, NPV, and AUC, especially in the combination of M-CSF with comparative tumor marker (78%;65%;0.866, respectively) and TIMP-2 with comparative tumor marker (84%;71%;0.895, respectively).
These findings suggest the usefulness of the tested parameters in the diagnosis of BC. However, the highest usefulness in the diagnostics of early BC (stage I and II) was found in case of TIMP-2 (particularly for differential diagnosis between BC and benign breast tumor) and M-CSF, especially with CA 15-3, which could be a new diagnostic panel.
巨噬细胞集落刺激因子(M-CSF)、基质金属蛋白酶-2(MMP-2)及其抑制剂金属蛋白酶组织抑制因子-2(TIMP-2)可能在乳腺癌(BC)的发病机制和增殖过程中发挥作用。本文研究了这些参数在BC患者中的血浆水平及其诊断效用,并与CA 15-3进行比较,同时与对照组(良性乳腺肿瘤患者和健康受试者)进行关联分析。
采用免疫酶联法(ELISA)测定所测参数的血浆水平,采用化学发光法(CMIA)测定CA 15-3。
我们的结果显示,BC患者与健康受试者或良性乳腺肿瘤患者在所测参数和CA 15-3的浓度上存在显著差异。与健康对照组相比,仅TIMP-2的血浆水平在所有肿瘤分期(I - IV期)均显著升高。在总BC组中,M-CSF和TIMP-2值在诊断敏感性、特异性、阳性和阴性检测结果的预测值(PPV、NPV)以及ROC曲线下面积(AUC)方面与CA 15-3值相当。所测参数与CA 15-3联合使用可提高敏感性、NPV和AUC,尤其是M-CSF与对照肿瘤标志物联合使用时(分别为78%;65%;0.866)以及TIMP-2与对照肿瘤标志物联合使用时(分别为84%;71%;0.895)。
这些发现表明所测参数在BC诊断中具有实用性。然而,在早期BC(I期和II期)诊断中,TIMP-2(特别是用于BC与良性乳腺肿瘤的鉴别诊断)和M-CSF的实用性最高,尤其是与CA 15-3联合使用时,这可能构成一个新的诊断组合。