title: Serum levels of granulocyte colony-stimulating factor (G-CSF) and macrophage colony-stimulating factor (M-CSF) in pancreatic cancer patients.
abstract: BACKGROUND
  Pancreatic cancer is an aggressive malignancy of the gastrointestinal tract and one of the most lethal human cancers. It has been shown that endogenous cytokines, produced aberrantly in many malignancies, including pancreatic cancer, may act as autocrine growth factors or as indicators of the immune response to tumors. Granulocyte-colony stimulating factor (G-CSF) and macrophage-colony stimulating factor (M-CSF) are hematopoietic growth factors (HGFs), i.e., cytokines that induce proliferation of hematopoietic and cancer cells.
  
  
  METHODS
  Serum levels of G-CSF, M-CSF, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) were determined using immunoenzymatic assays in 62 patients with pancreatic cancer before and 30 days after surgery, and in 65 healthy controls.
  
  
  RESULTS
  Cancer patients had significantly higher levels of all parameters measured compared to healthy subjects, especially in non-resectable tumors. Higher values of diagnostic parameters [specificity, sensitivity and area under receiver operating characteristic (ROC) curve] were observed for M-CSF than G-CSF, and for combined use of M-CSF with CA 19-9. Based on Cox analysis, elevated preoperative serum M-CSF was a significant prognostic factor for patient survival, although not independent of tumor stage.
  
  
  CONCLUSIONS
  Our findings suggest the usefulness of M-CSF as a tumor marker for pancreatic cancer, especially in combination with CA 19-9.
authors.affiliation: Department of Biochemical Diagnostics, Medical University, Białystok, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Groblewska
authors.forename: Barbara
authors.initials: B
authors.lastname: Mroczko
authors.forename: Urszula
authors.initials: U
authors.lastname: Wereszczyńska-Siemiatkowska
authors.forename: Piotr
authors.initials: P
authors.lastname: Myśliwiec
authors.forename: Bogusław
authors.initials: B
authors.lastname: Kedra
authors.forename: Maciej
authors.initials: M
authors.lastname: Szmitkowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood; D016022:Case-Control Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood*; D006801:Humans; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D012372:ROC Curve; D012680:Sensitivity and Specificity; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D016179:Granulocyte Colony-Stimulating Factor; D016173:Macrophage Colony-Stimulating Factor