Abstract | BACKGROUND: Cytokeratins are epithelial markers whose expression is not lost during malignant transformation. Cyfra 21-1 is a cytokeratin-19 fragment that is soluble in serum and may be a useful circulating tumor marker. STUDY OBJECTIVE: The aims of this study were (1) to confirm sensitivity and specificity of Cyfra 21-1 in detecting non-small cell lung cancer (NSCLC) and especially the squamous cell subtype, (2) to assess the potential relationship between Cyfra 21-1 and disease stage of the disease in NSCLC, and (3) to evaluate prognostic effect of Cyfra 21-1 in NSCLC. METHODS: RESULTS: Using a threshold of 3.3 ng/mL for Cyfra 21-1, sensitivity and specificity were, respectively, 0.59 and 0.94 in NSCLC, 0.68 and 0.94 in the subgroup of the squamous cell carcinoma, and 0.19 and 0.94 in small cell lung cancer. Cyfra 21-1 levels were significantly higher in advanced NSCLC than in early-stage disease. All 29 patients with serum concentrations > 32 ng/mL had stage IIIB-IV and only one of 14 patients with stage I-II disease had Cyfra 21-1 level > 18 ng/mL. In the multivariate analysis of survival, Cyfra 21-1 was an independent prognostic factor along with performance status and disease stage in NSCLC. CONCLUSIONS:
Cyfra 21-1 is a sensitive and specific tumor marker of NSCLC, especially of squamous cell subtype. It also reflects the extent of the disease and has an independent prognostic role along with performance status and disease stage in NSCLC. IMPLICATIONS: A high level of Cyfra 21-1 in apparently early-stage NSCLC should be an indication for more extensive workup before thoracotomy. The independent prognostic role of Cyfra 21-1 level may be useful in stratifying populations with advanced NSCLC or early-stage resected NSCLC as elevated Cyfra 21-1 levels might identify those patients at high risk for treatment failure.
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Authors | B Wieskopf, C Demangeat, A Purohit, R Stenger, P Gries, H Kreisman, E Quoix |
Journal | Chest
(Chest)
Vol. 108
Issue 1
Pg. 163-9
(Jul 1995)
ISSN: 0012-3692 [Print] United States |
PMID | 7541742
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers, Tumor
- Keratins
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Topics |
- Adenocarcinoma
(blood)
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
(blood)
- Carcinoma, Non-Small-Cell Lung
(blood)
- Carcinoma, Squamous Cell
(blood)
- Female
- Humans
- Immunoradiometric Assay
- Keratins
(blood)
- Lung Diseases
(blood)
- Lung Neoplasms
(blood)
- Male
- Middle Aged
- Predictive Value of Tests
- Prospective Studies
- ROC Curve
- Sensitivity and Specificity
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