Lab Med Online.  2015 Jul;5(3):143-148. 10.3343/lmo.2015.5.3.143.

Diagnostic Utility of Serum Cytokeratin Fragment 21-1 in Patients with Lung Cancer

• Song S
• Yoo EH
• Cho HJ

• KMID: 1821782
• DOI: http://doi.org/10.3343/lmo.2015.5.3.143

Abstract

BACKGROUND
Lung cancer is the most lethal malignant neoplasm in the world. Serum cytokeratin fragment 21-1 (Cyfra 21-1) is a valuable tumor marker for detection of lung cancer, and it has good sensitivity and specificity. The aim of this study was to investigate the diagnostic value of Cyfra 21-1 levels in patients with lung cancer.
METHODS
We retrospectively reviewed 814 samples from 169 patients with lung cancer, 124 patients with benign pulmonary diseases, and 521 normal controls from health check-up clinic. Serum Cyfra 21-1 levels were determined with Architect CYFRA 21-1 kit (Abbott, USA) using Architect i2000 analyzer.
RESULTS
Median levels and interquartile ranges for Cyfra 21-1 in patients with lung cancer (non-small cell lung cancer: 3.16 [1.98, 9.00] ng/mL, small cell lung cancer: 3.32 [2.07, 5.20] ng/mL) were higher than those in patients with benign pulmonary diseases (1.50 [1.17, 2.17] ng/mL; P<0.01) and in normal controls (1.26 [0.93, 1.75] ng/mL; P<0.01). Sensitivity, specificity, positive predictive value, and negative predictive value for Cyfra 21-1 were 70.4%, 81.2%, 49.6%, and 91.3%, respectively. The area under the curve for Cyfra 21-1 was 0.839 (95% confidence interval, 0.802-0.877).
CONCLUSIONS
We concluded that Cyfra 21-1 may be useful in the diagnosis of lung cancer.

Keyword

Cyfra 21-1; Lung cancer; Tumor marker

MeSH Terms

Diagnosis
Humans
Keratins*
Lung Diseases
Lung Neoplasms*
Retrospective Studies
Sensitivity and Specificity
Small Cell Lung Carcinoma
Keratins

Figure

• 

  Fig. 1 Receiver operating characteristic (ROC) curve using serum Cyfra 21-1 level to discriminate between the lung cancer and control groups (A) (AUC = 0.839 [95% CI, 0.802-0.877]) and the squamous cell cancer and control groups (B) (AUC = 0.866 [95% CI, 0.810-0.922]).

• 

  Fig. 2 Positive rates of CEA and Cyfra 21-1 for lung cancer based on the stages of lung cancer.

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