Serum granulocyte macrophage-colony stimulating factor: a tumor marker in colorectal carcinoma?

Granulocyte macrophage colony-stimulating factor (GM-CSF) is a hematopoietic growth factor, 23 kDA molecular weight with a glycoprotein nature, which is also an immune modulator. The levels of GM-CSF and its role in the pathophysiology of several cancers such as ovarian, breast have been investigated. The aim of the present study was to determine the effect of GM-CSF and carcinoembryogenic antigen levels in predicting survival.

Plasma levels of GM-CSF were measured in 51 patients with previously untreated colorectal cancer patients and 21 healthy adults as normal controls. The clinicopathological features of colorectal carcinoma were determined at the time of blood collection. Patient staging was done according to tumor-node-metastasis (TNM) by American Joint Commission on Cancer (AJCC).

Plasma concentrations of GM-CSF in colorectal cancer patients (42.0 pg/ml) were statistically significant higher than normal controls (23.2 pg/ml) (p= 0.001). Statistically significant correlation was not determined between pretreatment GM-CSF levels and overall survival. On the other hand, stage of disease, carcinoembryogenic antigen and peripheral leukocyte counts were not correlated with GM-CSF levels.

This is the first report in which serum levels of GM-CSF, carcinoembriyogenic and peripheral leukocyte counts have been simultaneously evaluated in colorectal cancer patients. We found significantly elevated GM-CSF but the results suggested that serum GM-CSF may not be useful for clinical information in prognosis as a tumor marker in colorectal cancer.