title: Systematic review of CYFRA 21-1 as a prognostic indicator and its predictive correlation with clinicopathological features in Non-small Cell Lung Cancer: A meta-analysis.
abstract: OBJECTIVE
  To evaluate the value of Cytokeratin 19 fragment for its survival prognostic indicator and predictive correlation with clinicopathological features in Non-small Cell Lung Cancer.
  
  
  METHODS
  Eligible studies or databases for articles were retrieved via search systematically. Pooled effect was calculated to evaluate the association between Cytokeratin 19 fragment level and long-term overall survival, as well as the tumor clinicopathological features in Non-small Cell Lung Cancer patients. A fixed-effects or random-effects model was used to calculate the Pooled risk ratios (RRs) and corresponding 95 % confidence intervals (CIs).
  
  
  RESULTS
  Six studies were up to the selection criteria. This meta-analysis indicated that Cytokeratin 19 fragment high level expression correlated with lower 2-year overall survival (RR =0.47; 95%CI: 0.28-0.79), higher Tumor Node Metastasis stage (II+III+IV) (RR =1.43; 95%CI: 1.15-1.76) in Non-small Cell Lung Cancer. The pooled RR estimates indicated that there is no statistical significance of Cytokeratin 19 fragment level expression in the advanced Non-small Cell Lung Cancer (IIIB+IV) (RR =1.43, 95% CI: 0.85-2.43).
  
  
  CONCLUSIONS
  Cytokeratin 19 fragment is a negative prognosis indicator and its high level expression indicates higher Tumor Node Metastasis pathological stage (II+III+IV) in Non-small Cell Lung Cancer. In advanced Non-small Cell Lung Cancer, the level of serum Cytokeratin 19 fragment appears to provide more prognostic information than it does for clinical Tumor Node Metastasis stage information. Further studies are required to confirm our results.
authors.affiliation: Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Zipu
authors.initials: Z
authors.lastname: Yu
authors.affiliation: Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Guofei
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Maoying
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Sai
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Baiqin
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Shen
authors.affiliation: Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chai
mesh_terms: D000951:Antigens, Neoplasm / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000378:metabolism*; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053539:Keratin-19 / Q000097:blood*; D008175:Lung Neoplasms / Q000097:blood / Q000378:metabolism*; D016017:Odds Ratio; D011379:Prognosis; D016019:Survival Analysis; D015854:Up-Regulation
chemical_list: D000951:Antigens, Neoplasm; D053539:Keratin-19; C102012:antigen CYFRA21.1
keywords: 2-year overall survival; Cytokeratin 19 fragment (CYFRA 21-1); Non-small Cell Lung Cancer(NSCLC); clinicopathological features