title: The value of circulating CYFRA21-1 expression in patients with nasopharyngeal carcinoma: a study of 529 subjects.
abstract: BACKGROUND
  Early diagnosis of nasopharyngeal carcinoma (NPC) needs more reliable biomarkers. The aim of this study was to investigate serum cytokeratin 19 fragment 21.1 (CYFRA21-1) as an NPC biomarker based on data from a large sample.
  
  
  METHODS
  From October 2010 to February 2014, 529 subjects were enrolled and divided into three groups-NPC group (n = 274), healthy control group (n = 175) and nasal inflammatory disease group (n = 80). Serum CYFRA21-1 levels were measured prior to radiotherapy/chemoradiotherapy, and their associations with T, N, and clinical classification were determined. Receiver operating characteristic curve analysis was performed to discriminate the NPC group from the healthy control and nasal inflammatory disease groups. Three Epstein-Barr virus (EBV) antibodies and their correlations with serum CYFRA21-1 levels were analyzed.
  
  
  RESULTS
  Pretreatment serum CYFRA21-1 levels were significantly elevated in the NPC group compared with the other groups (p < 0.01), Furthermore, serum CYFRA21-1 levels decreased significantly after radiotherapy (p < 0.01). Serum CYFRA21-1 levels were closely related to T, N, and clinical classifications. The area under the curve, sensitivity and specificity of the serum CYFRA21-1 levels in the NPC patients were 0.89, 0.87 and 0.83, respectively. Strong correlations were observed between serum CYFRA21-1 levels and EBV antibodies.
  
  
  CONCLUSIONS
  Serum CYFRA21-1 may be a reliable and effective biomarker for NPC.
authors.affiliation: Department of Radiation Oncology, Eye, Ear, Nose and Throat, FuDan University, Fenyang Road 83, Shanghai, 200031, China.
authors.forename: Xin-Mao
authors.initials: XM
authors.lastname: Song
authors.affiliation: Department of Clinical Laboratory, Eye, Ear, Nose and Throat, FuDan University, Fenyang Road 83, Shanghai, 200031, China.
authors.forename: Zhu-Jian
authors.initials: ZJ
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Eye, Ear, Nose and Throat, FuDan University, Fenyang Road 83, Shanghai, 200031, China.
authors.forename: Wen-Jun
authors.initials: WJ
authors.lastname: Cao
authors.affiliation: Department of Radiation Oncology, Eye, Ear, Nose and Throat, FuDan University, Fenyang Road 83, Shanghai, 200031, China.
authors.lastname: Ji-Li
authors.affiliation: Department of Radiation Oncology, Eye, Ear, Nose and Throat, FuDan University, Fenyang Road 83, Shanghai, 200031, China.
authors.forename: Fu
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Eye, Ear, Nose and Throat, FuDan University, Fenyang Road 83, Shanghai, 200031, China. shengziwang@fudan.edu.cn.
authors.forename: Sheng-Zi
authors.initials: SZ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood; D002277:Carcinoma; D059248:Chemoradiotherapy / Q000379:methods*; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D053539:Keratin-19 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000097:blood / Q000473:pathology / Q000821:virology; D009367:Neoplasm Staging; D063868:Patient Outcome Assessment; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
chemical_list: D000914:Antibodies, Viral; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; C102012:antigen CYFRA21.1
keywords: Cytokeratin 19 fragment 21.1; Epstein–Barr virus antibodies; Nasopharyngeal carcinoma; Tumor biomarker