Prognostic impact of Cyfra21-1 and other serum markers in completely resected non-small cell lung cancer.
OBJECTIVE
The aim of this prospective study was to assess the prognostic impact of serum tumor markers (Cyfra21-1, carcinoembryonic antigen, neuron-specific enolase, squamous cell carcinoma-antigen and TPAcyk) in patients with non-small cell lung cancer (NSCLC) receiving complete resection.


METHODS
Sixty-seven patients with histologically proven NSCLC and complete resection of stage I-IIIA disease were included. The serum levels of all markers were measured using commercially available immunoassays.


RESULTS
With a median follow-up of 86 months for surviving patients, those with initial Cyfra21-1 serum levels higher than 3.57 ng/ml had a significantly worse prognosis (P=0.014). The remaining serum tumor markers showed no prognostic impact. In a Cox regression model, Cyfra21-1 proved to be an independent prognostic factor for both overall survival and disease-free interval. In addition, Cyfra21-1 sustained as an independent prognostic factor in completely resected stage I/II disease.


CONCLUSIONS
With a cut-off value of 3.57 ng/ml, Cyfra 21-1 was an independent prognostic factor for survival in NSCLC-patients with complete resection. Further evaluation is needed, particularly in stage I/II disease. When the prognostic impact is confirmed with larger patient numbers this may contribute to the identification of stratification variables for future treatment approaches of NSCLC.
Reinmuth
Niels
N
Department of Medicine, Westfälische Wilhelms-Universität, 48129, Münster, Germany. reinmut@uni-muenster.de
Brandt
Burkhard
B
Semik
Michael
M
Kunze
Wolf-Peter
WP
Achatzy
Richard
R
Scheld
Hans H
HH
Broermann
Petra
P
Berdel
Wolfgang E
WE
Macha
Hans N
HN
Thomas
Michael
M
D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053539:Keratin-19; D007633:Keratins; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D015843:Serpins; D016019:Survival Analysis; D019396:Tissue Polypeptide Antigen / Q000097:blood
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D015843:Serpins; D019396:Tissue Polypeptide Antigen; C102012:antigen CYFRA21.1; C051072:squamous cell carcinoma-related antigen; D007633:Keratins; D010751:Phosphopyruvate Hydratase