The important role of circulating CYFRA21-1 in metastasis diagnosis and prognostic value compared with carcinoembryonic antigen and neuron-specific enolase in lung cancer patients

BMC Cancer

Research Article

Dan Pu¹  Zhixin Qiu²  Ping Zhou²  Yuting Jing²  Shuang Zhao²  Dan Liu²  Weimin Li²  Lei Li²  Yalun Li²  He Yu²  Yanqi He²  Yanwen Wang³  Yihan Zhu³  Li Zhang³ 

[1] Clinic Skill Center, West China Hospital, Sichuan University, 610041, Chengdu, Sichuan Province, People’s Republic of China;Department of Respiratory Medicine, West China Hospital, Sichuan University, 610041, Chengdu, Sichuan Province, People’s Republic of China;Lab of Pathology, West China Hospital, Sichuan University, 610041, Chengdu, Sichuan Province, People’s Republic of China;

关键词: Lung cancer patients;    Biomarkers;    CYFRA21-1;    CEA;    NSE;    Metastasis;    Prognosis;   

DOI  :  10.1186/s12885-017-3070-6

 received in 2015-11-20, accepted in 2017-01-18,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe roles of carcinoembryonic antigen (CEA), cytokeratin 19 fragments (CYFRA21-1) and neuron-specific enolase (NSE) in metastases occurrence and poor diagnosis in specific histological classifications of lung cancer need further exploring. In this study, we investigated relationship between elevated levels of three biomarkers of CEA, CYFRA21-1 and NSE (individually and in combination) and metastasis, survival status and prognosis in lung cancer patients.MethodsEight hundred and sixty eight lung cancer patients including adenocarcinoma (ADC, N = 445), squamous cell carcinoma (SCC, N = 215), small cell lung cancer (SCLC, N = 159) and other types (N = 49) were categorized into negative, moderate and high groups according to serum levels of biomarkers, and were then categorized into negative, single, double and triple groups according to any positive combination of three biomarkers. The cutoff values of three biomarkers for groupings were developed on the training group (N = 432) and verified in a validation group (N = 436). Clinical and laboratory characteristics were then assessed for correlation with occurrence of metastasis, survival status and prognosis between the two groups. Further correlation analyses were also conducted by different subtypes (ADC, SCC and SCLC) and tumor stages (I + II, III and IV) of lung cancers.ResultsThe consistent results between training and validation group confirmed the rationality of grouping methods. CYFRA21-1 levels had stronger association with metastases and survival status than CEA and NSE in all lung cancer patients. When stratified by subtypes, these significances only existed in ADC patients for CYFRA21-1. Cox regression analyses showed that CYFRA21-1 and NSE were independent prognostic factors for lung cancer patients. However, only CYFRA21-1 was an independent prognostic factor in ADC and SCLC patients subtypes. Cox-regression results also indicated that CYFRA21-1 could act as independent prognostic factor in different stages (I + II, III and IV) of lung cancer.ConclusionCYFRA21-1 was more important in metastasis occurrence and in predicting poor prognosis in lung cancer patients than CEA, NSE and positive numbers of biomarkers.

【 授权许可】

CC BY   
© The Author(s). 2017