Prognostic value of serum cytokeratin 19 fragments (Cyfra 21-1) in patients with non-small cell lung cancer

Abstract

The role of serum CYFRA 21-1 level in patients with non-small cell lung cancer (NSCLC) remains to be defined. To re-evaluate the impact of serum CYFRA 21-1 in NSCLC survival, we performed this meta-analysis. Databases were searched to identify relevant studies reported after the publication of a meta-analysis in 2004. Totally, 31 studies with 6394 patients were included in this meta-analysis. The pooled Hazard ratios (HRs) indicated that high CYFRA 21-1 level was associated with poor prognosis on overall survival (OS) in patients with NSCLC (HR = 1.60; 95%CI = 1.36–1.89; P < 0.001). The pooled HRs were 2.18 (95%CI = 1.70, 2.80; P = 0.347) for patients at stage I–IIIA and 1.47 (95%CI = 1.02, 2.11; P < 0.001) for stage IIIB–IV. When stratified by surgical intervention, pooled HRs were 1.94 (95%CI = 1.42–2.67; P < 0.001) for studies with surgery and 1.24 (95%CI = 0.79–1.95; P < 0.001) for studies without surgery. Significant associations were also found in the patients treated with EGFR-TKIs (HR = 1.83; 95%CI = 1.31–2.58; P = 0.011) and platinum-based regimen (HR = 1.53; 95%CI = 1.18–1.99; P = 0.001). Meta-analysis of CYFRA 21-1 related to PFS was performed and pooled HR was 1.41 (95%CI = 1.19–1.69; P < 0.001). Our results indicate that high level of serum CYFRA 21-1 is a negative prognostic indicator of patients with NSCLC.

Cell Death, Inflammation, Tumor Burden, and Proliferation Blood Biomarkers Predict Lung Cancer Radiotherapy Response and Correlate With Tumor Volume and Proliferation Imaging

“…This is in agreement with previous studies that reported that early reduction in CYFRA 21-1 is associated with improved NSCLC treatment response. 35 , 37 , 38 , 39 Very few studies have established the prognostic effect of baseline CYFRA 21-1 in SCLC patients. 40 , 41 Although our study only included 16 SCLC patients (20.5%), it suggests the potential utility of this marker, when quantified early during treatment, in these patients.…”

Potential for the blood-based biomarkers cytokeratin 19 fragment (CYFRA 21-1) and human epididymal protein 4 (HE4) to detect recurrence during monitoring after surgical resection of adenocarcinoma of the lung

“…There is evidence to suggest that the biomarkers cytokeratin 19 fragment (CYFRA 21-1) and human epididymis protein 4 (HE4) may be useful in the diagnosis, prognosis, and treatment monitoring of NSCLC [21][22][23][24][25][26][27][28][29][30][31]. These biomarker levels appear to be higher in patients with advanced disease, those with nodal and/or distant metastases, and in those with a poor performance status [27,32,33], with the majority of data regarding the prognostic utility of these biomarkers reported in the advanced disease setting [21,22,24,[28][29][30][31] or across all stages of disease [25,34,35]. However, some evidence exists for CYFRA 21-1 in early-stage NSCLC [36][37][38], including findings from a retrospective analysis of 515 patients with NSCLC who underwent surgery, which showed that in patients with stage I disease, 3-year survival rates were lower in patients with elevated preoperative serum levels of CYFRA 21-1 than in those with normal CYFRA 21-1 levels (60.2% versus 78.4%; p = 0.015) [39].…”

Long-term survival of a patient with small cell carcinoma of the stomach with metachronous lung metastases treated by multimodal therapy: a case report

“…NSE is reportedly a sensitive tumor marker for neuroendocrine tumors [ 15 ], but the NSE level was within the reference range in the present case. Although CYFRA is a sensitive marker for non-small-cell lung cancer [ 16 ], it was a very sensitive marker for progression and metastases in the present case (Fig. 7 ).…”