title: Clinical significance of CYFRA21-1, Scc-Ag and telomerase activity in serum and pleural effusion of patients with squamous-cell lung cancer.
abstract: BACKGROUND
  The aim was to evaluate the diagnostic value of CYFRA21-1, Scc-Ag and telomerase activity in serum and pleural effusion in patients with squamous-cell lung cancer. CYFRA21-1, Scc-Ag and telomerase activity were measured using electrochemiluminescent, microparticle enzyme immunoassay and telomeric-repeat amplification protocol.
  
  
  RESULTS
  We evaluated 302 patients diagnosed with squamous-cell lung cancer and 153 patients diagnosed with benign lung diseases. All examined tumor markers were higher in pleural effusion than serum (p < 0.05). The areas under receiver operating characteristic curve of CYFRA21-1 and Scc-Ag were higher in pleural effusion than serum. Optimizations for sensitivity, specificity and specificity in pleural effusion for CYFRA21-1 + Scc-Ag: 88.24, 97.17 and 92.79%; telomerase activity + Scc-Ag: 90.2, 95.28 and 92.8%; CYFRA21-1, Scc-Ag + telomerase activity: 91.18, 96.86 and 94.64%; respectively. Optimizations for sensitivity, specificity and specificity in serum for CYFRA21-1 + telomerase activity: 81.37, 94.34 and 87.98%; CYFRA21-1 + Scc-Ag and telomerase activity: 87.25, 93.08 and 90.8%; respectively.
  
  
  CONCLUSIONS
  The combined detection of tumor markers in pleural effusion showed higher sensitivity, better accuracy and higher clinical value than serum and single detection. However, the cost-effectiveness of these methods should be considered in clinical practice.
authors.affiliation: Department of Respiratory Medicine, the Fourth Affiliated Hospital of Harbin Medical University, No. 37, Yi Yuan Street, Nan Gang District, Harbin 150001, China. liulei110052@163.com
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Zhu
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000032:analysis* / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007118:Immunoassay; D053539:Keratin-19 / Q000032:analysis* / Q000097:blood; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D021141:Nucleic Acid Amplification Techniques; D010996:Pleural Effusion / Q000378:metabolism*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D015843:Serpins / Q000032:analysis* / Q000097:blood; D019098:Telomerase / Q000097:blood / Q000378:metabolism*
chemical_list: D000951:Antigens, Neoplasm; D053539:Keratin-19; D015843:Serpins; C102012:antigen CYFRA21.1; C051072:squamous cell carcinoma-related antigen; D019098:Telomerase