CYFRA 21 -1: An Indicator of Survival and Therapeutic Effect in Lung Cancer

Abstract

CYFRA 21-1 is a new tumor marker using two different monoclonal antibodies which recognize the divergent epitope on the N- or C-terminal region of domain 2 of cytokeratin 19 fragment, respectively. In this study, we investigated the relationship between levels of CYFRA 21-1 and survival duration, as well as the efficacy of chemotherapy associated with changes in CYFRA 21-1. Serum samples were obtained from 87 patients with nonoperable lung cancer (35 cases with squamous-cell carcinoma, 33 with adenocarcinoma, 3 with large-cell carcinoma, and 16 with small-cell carcinoma). The cutoff point was set at 3.5 ng/ml. In a CYFRA 21-1 assay, significantly more patients with squamous-cell carcinoma and adenocarcinoma were positive compared to patients with small-cell and large-cell carcinomas (p = 0.0017). Following chemotherapy, blood levels of CYFRA 21-1 decreased significantly in responders versus nonresponders (p = 0.0246). A significant correlation was noted between survival periods and pretreatment levels of CYFRA 21-1 (p = 0.0036). The present study suggests that CYFRA 21-1 might be useful as a possible indicator of survival and therapeutic effect for lung cancer.

CYFRA 21-1 is a prognostic determinant in non-small-cell lung cancer: results of a meta-analysis in 2063 patients

“…The estimated cumulative population, not included in the metaanalysis measured by using the reported patient numbers in the methods section of the publications, was 764 patients. This represents seven studies and eight publications (Giovanella et al, 1995;Takei et al, 1997;Hirashima et al, 1998;Niklinski et al, 1998;Nisman et al, 1998Nisman et al, , 1999Foa et al, 1999;Kashiwabara et al, 2000; Table 2), all of them having reported a poor prognostic outcome for patients presenting with a high serum CYFRA 21-1 level, confirmed by multivariate analysis in four instances (Hirashima et al, 1998;Niklinski et al, 1998;Nisman et al, 1998Nisman et al, , 1999Foa et al, 1999).…”

“…By analysing the different prognostic studies (Ebert et al, 1993(Ebert et al, , 1997Pujol et al, 1993aPujol et al, , 1996Pujol et al, , 2001aGiovanella et al, 1995;Moro et al, 1995;Paesmans et al, 1995a;Wieskopf et al, 1995;Szturmowicz et al, 1996;Brechot et al, 1997;Hamzaoui et al, 1997;Takei et al, 1997;Hirashima et al, 1998;Niklinski et al, 1998;Nisman et al, 1998Nisman et al, , 1999Foa et al, 1999;Kashiwabara et al, 2000;Buccheri et al, 2003), one can observe that there are some uncertainties regarding the exact hazard ratio of risk of death associated with a high serum CYFRA 21-1 level insofar as the estimated values range from 1.05 (Moro et al, 1995) to 2.8 (Wieskopf et al, 1995). This discrepancy is puzzling and might reflect both the relatively small size of the studies and the inconstancy of co-variables introduced in the proportional hazards model.…”

Preoperative CYFRA 21-1 levels as a prognostic factor in c-stage I non-small cell lung cancer

“…Since then, many studies on the relationship between CYFRA 21-1 levels and NSCLC have been reported, and CYFRA 21-1 is now known as a useful tumor marker for NSCLC with high positive rates [3][4][5]. Variation in CYFRA 21-1 levels among different histological groups in NSCLC has also been reported, showing higher sensitivities in squamous cell carcinoma than in adenocarcinoma [5,11]. In regards to squamous cell carcinoma cases, Reinmuth et al [5] demonstrated that CYFRA 21-1 is the marker with the highest sensitivity compared to other markers, such as carcinoembryonic antigen and squamous cell carcinoma antigen.…”

Clinical value of CYFRA 21.1, carcinoembryonic antigen, neurone-specific enolase, tissue polypeptide specific antigen and tissue polypeptide antigen in the diagnosis of lung cancer

“…In comparative studies cytokeratin fragment detected by antibodies BM 19-21 and KS 19-1 (CYFRA 21.1) has proved to be the marker of choice in non-small cell lung cancer [3][4][5][6][7][8][9][10][11] and is also of independent prognostic value [3,12,13].…”