Serum levels of macrophage colony-stimulating factor in trophoblastic disease.
OBJECTIVE
The aims of this study were to measure levels of colony stimulating factor (CSF-1) in patients with trophoblastic disease, to determine whether such measurement may be useful to supplement measurement of the prognostically reliable human chorionic gonadotrophin (hCG), and to assess whether measurement of CSF-1 may be helpful in predicting requirement for chemotherapy in patients with hydatidiform mole.


METHODS
Serial weekly serum samples were selected for CSF-1 assay from representative diagnostic groups of patients with trophoblastic disease: hydatidiform-mole with spontaneous resolution, low-risk post-hydatidiform-mole trophoblastic tumor, partial hydatidiform mole, high-risk metastatic gestational trophoblastic tumor, primary ovarian choriocarcinoma, and placental site trophoblastic tumor. hCG was measured by an in-house radioimmunoassay that measures all parts of the hCG molecule. CSF-1 was measured by radioimmunoassay with (125)I-labeled recombinant CSF-1. The upper level of normal CSF-1 was taken as 8 ng/ml.


RESULTS
In this study of 45 patients with trophoblastic disease, some very high levels of CSF-1 were encountered. In a few patients there was dramatic correlation with hCG. Generally, however, CSF-1 and hCG did not correlate. CSF-1 was frequently not elevated when hCG was still significantly elevated and conversely CSF-1 was elevated when hCG was negative.


CONCLUSIONS
The measurement of CSF-1 does not appear to be useful in managing trophoblastic disease as it does not correlate with the level of hCG. Occasionally, high levels of CSF-1 were found in patients with trophoblastic disease.
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510, USA.
E I
EI
Kohorn
B M
BM
Kacinski
E R
ER
Stanley
D000293:Adolescent; D000328:Adult; D000368:Aged; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000097:blood / Q000188:drug therapy; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D011863:Radioimmunoassay; D012307:Risk Factors; D014328:Trophoblastic Neoplasms / Q000097:blood*; D014594:Uterine Neoplasms / Q000097:blood*
D006063:Chorionic Gonadotropin; D016173:Macrophage Colony-Stimulating Factor