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Serum granulocyte colony-stimulating factor levels in patients with urinary bladder tumour and various urological malignancies.

OBJECTIVES
To measure the serum levels of granulocyte colony-stimulating factor (G-CSF) in patients with urinary bladder tumour (UBT) or various urological malignant tumours, and to assess G-CSF production by tumour cells.


PATIENTS AND METHODS
Peripheral blood was obtained, before operation or anti-cancer therapy, from 141 patients with UBT, 37 patients with other urological malignant tumours (21 with renal cell carcinoma, nine with renal pelvic or ureteric tumours, five with prostatic cancer, and two with testicular cancer), 38 patients with benign urological diseases (21 with benign prostatic hypertrophy, 11 with urolithiasis and six with a varicocele), and from 15 healthy donors. The serum G-CSF levels were quantified using an enzyme immunoassay.


RESULTS
Of 141 patients with UBT, 13 showed elevated serum G-CSF levels above the sensitivity of the assay (30 pg/mL) with a mean value of 328 pg/mL. The serum levels in normal healthy donors and in patients with prostatic cancer, testicular cancer or varicocele were < 30 pg/mL, while the levels were > 30 pg/mL in two of nine patients with renal pelvic or ureteric tumour (mean 754 pg/mL) and in one of 21 patients with renal cell carcinoma (40 pg/mL). The levels of serum G-CSF in several patients with benign prostatic hypertrophy or urolithiasis were also elevated, but the mean levels were low. The serum G-CSF levels in patients with UBT correlated with the increase of grade and the progression of the stage of UBT. Furthermore, patients with UBT and an undetectable level of serum G-CSF had higher disease-specific survival rates at the 5-year follow-up when compared with those with an elevated level of serum G-CSF. There was a positive correlation between serum G-CSF levels and white blood cell counts. T24 and J82 UBT cell lines and freshly separated tumour cells derived from the patient whose serum G-CSF level was high produced G-CSF.


CONCLUSION
These results suggest that elevated serum G-CSF level might be associated with a poor prognosis in patients with UBT and be due to the production of G-CSF by UBT cells.