title: The concentration of CYFRA 21-1, NSE and CEA in cerebro-spinal fluid can be useful indicators for diagnosis of meningeal carcinomatosis of lung cancer.
abstract: OBJECTIVE
  We aimed to investigate the concentration of CYFRA 21-1, NSE and CEA in cerebro-spinal fluid (CSF) and to explore their clinical value in the meningeal carcinomatosis (MC) of lung cancer. So that, sensitive and specificity of CSF examination can be improved in the initial diagnosis of MC.
  
  
  METHODS
  A total of 35 lung cancer patients and 35 patients with benign brain tumor in the same period enrolled in this study. The concentrations of tumor markers CEA, CYFRA 21-1 and NSE in CSF and peripheral blood were examined.
  
  
  RESULTS
  The concentrations of three tumor markers of CYFRA 21-1, NSE and CEA in blood serum and CSF were obviously higher than that of benign disease group. In MC patients, the concentrations of three tumor markers of CYFRA 21-1, NSE and CEA in blood serum were significant lower than that in CSF. The maximum of Youden's index was identified as the cutoff value of indicator of MC in three tumor markers in CSF which were CEA > 4.7 μg/L, NSE > 14.6 μg/L and CYFRA21-1 > 5.5 μg/L respectively. Based on the cutoff values, the CEA had the highest sensitivity while the CYFRA21-1 had the highest specificitiy. Three tumor markers in the CSF had higher positive rate than those in blood serum. We combined the levels of CEA, NSE and CYFRA21-1 in CSF to diagnosis of MC. Positive of CEA or CYFRA21-1 had the greatest sensitivity of 100% while the specificity of 91.4%; the positive of both CEA and CYFRA21-1 had the highest specificity of 100% while the sensitivity of 74.3%. Both positive predictive value and negative predictive value were 100% when combination positive were confirmed when the all three markers were positive.
  
  
  CONCLUSIONS
  The combination of CEA and CYFRA21-1 can be recommended in early screening of meningeal carcinoma. Especially, for the patient who was difficult to be diagnosed by CSF histology and MRI, it will be a useful auxiliary marker in diagnosis of MC. The combination of CEA, NSE and CYFRA21-1 can be an effective clinically confirmation and exclusively diagnose indictor of MC.
authors.affiliation: Department of Neuro-oncology and Neurosurgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Wang
authors.forename: Yingzhe
authors.initials: Y
authors.lastname: Piao
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhang
authors.forename: Wenliang
authors.initials: W
authors.lastname: Li
authors.forename: Xishan
authors.initials: X
authors.lastname: Hao
mesh_terms: D000951:Antigens, Neoplasm / Q000097:blood / Q000134:cerebrospinal fluid*; D014408:Biomarkers, Tumor / Q000097:blood / Q000134:cerebrospinal fluid*; D002272:Carcinoembryonic Antigen / Q000097:blood / Q000134:cerebrospinal fluid*; D006801:Humans; D053539:Keratin-19 / Q000097:blood / Q000134:cerebrospinal fluid*; D008175:Lung Neoplasms / Q000134:cerebrospinal fluid* / Q000473:pathology; D055756:Meningeal Carcinomatosis / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000556:secondary; D010751:Phosphopyruvate Hydratase / Q000097:blood / Q000134:cerebrospinal fluid*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; C102012:antigen CYFRA21.1; D010751:Phosphopyruvate Hydratase