MACROPHAGE-COLONY-STIMULATING FACTOR-1, A CLINICALLY USEFUL TUMOR-MARKER IN ENDOMETRIAL ADENOCARCINOMA - COMPARISON WITH CA-125 AND THE AMINOTERMINAL PROPEPTIDE OF TYPE-III PROCOLLAGEN

OBJECTIVE: We investigated the clinical utility of macrophage colony-s timulating factor 1 versus CA 125 and the aminoterminal propeptide of type III procollagen in endometrial carcinoma. STUDY DESIGN: Serum lev els of the three substances were measured in 159 patients with untreat ed endometrial adenocarcinoma and in 24 patients treated with cytotoxi c chemotherapy for recurrent endometrial adenocarcinoma. RESULTS: Init ial concentrations of colony-stimulating factor 1, CA 125, and the ami noterminal peptide of type III procollagen were above the normal range in 73%, 11%, and 27%, respectively, of the patients. Colony-stimulati ng factor 1 levels correlated with those of the aminoterminal peptide of type III procollagen (r = 0.3, p = 0.002) and CA 125 (r = 0.20, p = 0.036) in the total group and with those of the aminoterminal peptide of type III procollagen in stage I and II patients (r = 0.3, p = 0.00 23). Colony-stimulating factor 1 levels correlated significantly with tumor grade, whereas those of CA 125 and the aminoterminal peptide of type III procollagen correlated more closely with clinical stage. Mean colony-stimulating factor 1 levels (9.6 vs 7.7 ng/ml, p = 0.04) and t he frequency of elevated CA 125 levels (31% vs 8%, p = 0.048) were hig her in patients with poor prognosis than in those with good prognosis. Colony-stimulating factor 1, the aminoterminal peptide of type III pr ocollagen, and CA 125 levels were useful in monitoring clinical behavi or of the disease in 88%, 79%, and 63% of the cases, respectively. Lev els of all three markers rose with disease progression, whereas colony -stimulating factor 1 and the aminoterminal peptide of type III procol lagen fell with clinical responses to therapy. CONCLUSION: Elevated se rum colony-stimulating factor I levels were the most accurate indicato r of the presence and activity (progression, stabilization, or regress ion) of primary or recurrent disease. Accuracy was not further enhance d by measurement of CA 125 or the aminoterminal peptide of type III pr ocollagen levels.