title: Feasibility of CYFRA 21-1 as a serum biomarker for the detection of colorectal adenoma and advanced colorectal adenoma in people over the age of 45.
abstract: BACKGROUND
  Colon adenoma (CA) is a premalignant lesion of colorectal cancer, and its early removal is closely associated with more prolonged survival in the general population. In this study, we aimed to evaluate the relationship between diverse biologic markers and a newly diagnosed CA and to predict the clinical possibility of cytokeratin-19 soluble in serum fragment (CYFRA 21-1) as a screening tool in asymptomatic adults aged over 45 years.
  
  
  METHODS
  Four hundred and seventy-nine patients with a histologically confirmed CA or benign colon polyp (BCP), 76 patients with only benign colorectal diseases and 223 negative controls with no CA or BCP detected on colonofibroscopy were investigated. Multiple tumor markers and biochemical markers were simultaneously checked by radioimmunoassay and enzyme immunoassay.
  
  
  RESULTS
  The CYFRA 21-1 alone showed significant stepwise contrastive potential among the three groups (P<.001). Based on the receiver operating characteristic (ROC) analysis, Area under the curve (AUC) for CYFRA 21-1, with a value of 0.732 (95% confidence interval, 0.656-0.809, P<.001) for differentiating between negative controls and patients with advanced colon adenoma, was comparatively the highest among all analyzed factors. The sensitivity of CYFRA 21-1 was significantly higher than that of the other tumor markers in the diagnosis of CA and advanced CA, respectively (P<.001).
  
  
  CONCLUSIONS
  Considering the results of our study, CYFRA 21-1 showed a significant diagnostic performance and significant stepwise comparative potential in differentiating patients with CA from benign controls. CYFRA 21-1 could be a simple and effective screening test for the diagnosis of CA.
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, South Korea.
authors.forename: Do Hyoung
authors.initials: DH
authors.lastname: Lim
authors.affiliation: Department of Nuclear Medicine, Dankook University College of Medicine, Cheonan, South Korea.
authors.forename: Jai Hyuen
authors.identifier: http://orcid.org/0000-0002-1247-0849
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, South Korea.
authors.forename: Jong Wan
authors.initials: JW
authors.lastname: Kim
mesh_terms: D000236:Adenoma / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D003111:Colonic Polyps / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; C102012:antigen CYFRA21.1
keywords: CYFRA 21-1; benign polyp; colon adenoma; colonofibroscopy; colorectal cancer