title: Preoperative evaluation of macrophage colony-stimulating factor levels in patients with endometrial cancer.
abstract: OBJECTIVE
  Our purpose was to examine the relationship between preoperative serum levels of macrophage colony-stimulating factor, alone and in combination with CA 125, and the presence of prognostic clinicopathologic factors and subclinical metastases in women with endometrial cancer.
  
  
  METHODS
  Ninety-two women who underwent primary exploration for endometrial adenocarcinoma had preoperative serum samples evaluated for macrophage colony-stimulating factor and CA 125 levels. Multivariate analysis was used to determine the associations of surgicopathologic findings with macrophage colony-stimulating factor and CA 125 levels. Logistic regression analysis was used to identify factors associated with the risk of extrauterine disease. The association of macrophage colony-stimulating factor and CA 125 levels with stage, grade, and depth of myometrial invasion and histologic characteristics were analyzed with Fisher's two-tailed exact test.
  
  
  RESULTS
  Elevated levels of macrophage colony-stimulating factor were not associated with depth of myometrial invasion, histologic grade, or histologic cell type; however, advanced stage (p = 0.02) and the presence of lymph node metastases (p = 0.04) were associated with elevated levels. Sensitivity and specificity of macrophage colony-stimulating factor for predicting extrauterine disease were 42% and 89%, respectively. If either an elevated macrophage colony-stimulating factor or an elevated CA 125 level was used to predict extrauterine disease, the sensitivity was increased to 67% but the specificity was decreased to 78%. Macrophage colony-stimulating factor elevations predicted lymph node metastases with a sensitivity of 50% and a specificity of 86%. A multivariate regression model showed CA 125 to be the most significant predictor of extrauterine disease; macrophage colony-stimulating factor also contributed prognostic information (p = 0.02). The sensitivity and specificity of the multivariate model for predicting extrauterine disease were 75% and 73%, respectively.
  
  
  CONCLUSIONS
  Macrophage colony-stimulating factor and CA 125 are neither sensitive nor specific enough to be used as predictors of the presence or absence of extrauterine disease in patients with endometrial cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
authors.forename: G
authors.initials: G
authors.lastname: Olt
authors.forename: J
authors.initials: J
authors.lastname: Soper
authors.forename: S
authors.initials: S
authors.lastname: Ramakrishnan
authors.forename: F
authors.initials: F
authors.lastname: Xu
authors.forename: A
authors.initials: A
authors.lastname: Berchuck
authors.forename: D
authors.initials: D
authors.lastname: Clarke-Pearson
authors.forename: R
authors.initials: R
authors.lastname: Dodge
authors.forename: R C
authors.initials: RC
authors.lastname: Bast
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000473:pathology / Q000601:surgery; D018394:CA-125 Antigen / Q000097:blood; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood*; D015999:Multivariate Analysis; D009215:Myometrium / Q000473:pathology; D009367:Neoplasm Staging; D011300:Preoperative Care; D012044:Regression Analysis; D012680:Sensitivity and Specificity
chemical_list: D018394:CA-125 Antigen; D016173:Macrophage Colony-Stimulating Factor