title: Diagnostic Value of CYFRA 21-1 in the Cerebrospinal Fluid for Leptomeningeal Metastasis.
abstract: Cerebrospinal fluid (CSF) cytology has low sensitivity for leptomeningeal metastasis (LM); thus, new markers are needed to improve the diagnostic accuracy of LM. We measured carcinoembryonic antigen (CEA) and cytokeratin 19 fragments (CYFRA 21-1) in paired samples of CSF and serum from patients with LM and patients with nonmalignant neurological diseases (NMNDs) as controls. Receiver operating curve analysis was performed to assess their diagnostic accuracy for LM. In patients with NMNDs, CEA and CYFRA 21-1 levels in the CSF were significantly lower than the serum levels. In patients with LM, there was no significant difference between the CSF and serum CEA levels, whereas the CYFRA 21-1 levels were significantly higher in the CSF than the serum. CSF/serum quotients of CYFRA 21-1 were higher than those of CEA in patients with LM and patients with NMNDs. CSF CYFRA 21-1 and CSF/serum quotient of CYFRA 21-1 had high accuracy for differentiating LM from NMNDs that was similar to CSF CEA and CSF/serum quotient of CYFRA 21-1, whereas serum CYFRA 21-1 is of poor diagnostic value. Measurement of CSF CYFRA 21-1 should not be overlooked in patients with suspected LM, even if the serum CYFRA 21-1 level is within normal limits.
authors.affiliation: Department of Neurology, PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Neurology, PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China; Department of Neurology, PLA General Hospital, Hainan Branch, Haitang Bay, Sanya, Hainan 57200, China.
authors.forename: Chenglin
authors.identifier: 0000-0002-2455-6930
authors.initials: C
authors.lastname: Tian
authors.affiliation: Department of Neurology, PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China; Department of Neurology, PLA General Hospital, Hainan Branch, Haitang Bay, Sanya, Hainan 57200, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Department of Neurology, PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Hao
authors.affiliation: Department of Neurology, PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Na
authors.initials: N
authors.lastname: Zhao
authors.affiliation: Department of Neurology, PLA General Hospital, No. 28, Fuxing Road, Beijing 100853, China.
authors.forename: Zhijie
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000134:cerebrospinal fluid*; D014408:Biomarkers, Tumor / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000134:cerebrospinal fluid*; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000556:secondary*; D008875:Middle Aged
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; C102012:antigen CYFRA21.1