Preoperative CYFRA 21-1 level as a prognostic indicator in resected primary squamous cell lung cancer

Abstract

Summary The CYFRA 21-1 assay is a test that has been developed recently for detection of a cytokeratin 19 fragment in serum. A diagnostic role for CYFRA 21-1 has already been proposed. The question of whether this marker is prognostically significant is important in clarifying the role of CYFRA 21-1 in clinical practice. The aim of this study was to evaluate the prognostic significance of elevated preoperative CYFRA 21-1 levels in patients with resected primary squamous-cell lung cancer (SqCC). Serum levels of CYFRA 21-1 were measured using an immunoradiometric assay (CIS bio) in 91 patients with operable SqCC. Survival and disease-free survival curves related to initial levels of this marker were estimated using the Kaplan-Meier method. In the univariate analysis the log-rank test and the log-rank test for trend were used. In the multivariate analysis the stratified log-rank test and the proportional hazard model were used. Elevated preoperative CYFRA 21-1 levels were identified in 55% of patients with SqCC. The number of patients with elevated levels of this marker increased with TNM stage (P=0.0001). In univariate analysis elevated levels of CYFRA 21-1 were significantly associated with poor overall survival (P<0.00005) and with disease-free survival (P<0.00005). In multivariate analysis elevated levels of this marker were also found to be associated with poor overall and disease-free survival (P=0.01 and P=0.003 respectively). In conclusion, CYFRA 21-1 may be an independent prognostic parameter of survival and tumour relapse in SqCC and may be useful in identifying resected SqCC patients at high risk of treatment failure.

The prognostic value of the tumour marker Cyfra 21-1 in carcinoma of head and neck and its role in early detection of recurrent disease

“…According to our findings, re-elevation of the marker had a positive predictive value of 75% (10 cases of recurrence, 2 deaths, 4 NED). These findings are in agreement with the results reported by Niklinski et al in squamous cell lung cancer (Niklinski et al, 1996). Similar findings in squamous cell lung cancer were also reported by Van der Gaast et al ( Van der Gaast et al, 1994).…”

“…Our findings are in agreement with those of Pujol et al (Pujol et al, 1993(Pujol et al, , 1996, who report that the prognostic significance obtained by Cyfra 21-1 in squamous cell lung cancer is independent and adds to the information obtained from other classic prognostic factors, such as extent of the disease, weight loss, performance status, etc. Niklinski and colleagues report that Cyfra 21-1 may be an independent prognostic parameter of survival and tumour relapse in squamous cell lung cancer (Niklinski et al, 1996).…”

Prognostic Value of Serum Tumor Markers in Patients with Lung Cancer

“…Also, CYFRA was an independent prognostic factor as high serum levels of this tumor marker at the time of diagnosis were related with a poor survival in the NSCLC and SQCLC groups. These findings are in agreement with those of previous studies [12, 13, 14]. …”

Preoperative CYFRA 21-1 level as a prognostic indicator in resected nonsmall cell lung cancer

“…Following these observations the relationship between the elevated CYFRA 21-1 levels and clinical outcome of patients with resected squamous cell lung carcinoma was investigated. CYFRA 21-1 was found to be an independent prognostic factor of survival and tumour relapse [24]. In addition, the significant role of CYFRA 21-1 in the postoperative monitoring of patients with squamous cell type lung cancer for the detection of tumour recurrence has recently been reported [25].…”