title: Prognostic value of combination of Cyfra 21-1, CEA and NSE in patients with advanced non-small cell lung cancer.
abstract: OBJECTIVE
  To assess the value of Cyfra 21-1, carcino-embryonic antigen (CEA) and neuron-specific enolase (NSE) combined, all three together as prognostic factors in advanced stage non-small cell lung cancer (NSCLC) patients.
  
  
  METHODS
  Serum samples from untreated NSCLC patients were prospectively collected. All assays were performed using commercial kits blind to clinical information. Serum levels of CEA, NSE and Cyfra 21-1 higher than 10, 13 and 3.5 ng/ml, respectively, were considered as elevated.
  
  
  RESULTS
  264 patients (men, 87%), with Performans Status (PS) of 0/1 in 80% and stage IV disease in 65% were studied. Cyfra 21-1, CEA and NSE were elevated in 52.5%, 41.8% and 33.2% of patients, respectively. Median survival was 9 months (range, 1-77). Cyfra 21-1, age, PS, stage as well as the combination of the three markers together correlated with prognosis in univariate analysis. Multivariate analysis demonstrated that age > or = 65 years (HR = 1.3 [1.02-1.70], p = 0.03), PS 2 (HR = 4.3 [3.13-6.11], p < 0.0001), Cyfra 21-1 > or = 3.5 ng/ml (HR = 1.3 [1.06-1.78], p = 0.01) and the combination of the three markers (HR = 1.06 [1.009-1.13], p = 0.02) remained prognostic determinants.
  
  
  CONCLUSIONS
  Combining Cyfra 21-1, NSE and CEA correlated with prognosis in a significant and independent manner.
authors.affiliation: Faculty of Medicine, Université de la méditerranée, Assistance Publique Hôpitaux de Marseille, Service d'Oncologie Thoracique, Marseille, Cedex 09, France. fabrice.barlesi@mail.ap-hm.fr
authors.forename: Fabrice
authors.initials: F
authors.lastname: Barlési
authors.forename: Céline
authors.initials: C
authors.lastname: Gimenez
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Torre
authors.forename: Christophe
authors.initials: C
authors.lastname: Doddoli
authors.forename: Julien
authors.initials: J
authors.lastname: Mancini
authors.forename: Laurent
authors.initials: L
authors.lastname: Greillier
authors.forename: François
authors.initials: F
authors.lastname: Roux
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Kleisbauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053539:Keratin-19; D007633:Keratins; D008175:Lung Neoplasms / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis
chemical_list: D000951:Antigens, Neoplasm; D015415:Biomarkers; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; C102012:antigen CYFRA21.1; D007633:Keratins; D010751:Phosphopyruvate Hydratase