title: The pretreatment plasma level and diagnostic utility of M-CSF in benign breast tumor and breast cancer patients.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  These results suggest that M-CSF is the good candidate for a breast cancer tumor marker.
authors.affiliation: Department of Biochemical Diagnostics, Medical University, Waszyngtona 15A, 15-269 Bialystok, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Ławicki
authors.forename: Maciej
authors.initials: M
authors.lastname: Szmitkowski
authors.forename: Marek
authors.initials: M
authors.lastname: Wojtukiewicz
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood* / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood*; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood*; D009367:Neoplasm Staging; D012372:ROC Curve; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D018396:Mucin-1; D011933:Reagent Kits, Diagnostic; D016173:Macrophage Colony-Stimulating Factor