CYFRA-21-1 DETERMINATION IN PATIENTS WITH NON-SMALL-CELL LUNG-CANCER - CLINICAL UTILITY FOR THE DEFECTION OF RECURRENCES

The aim of this study was to evaluate serial determinations of CYFRA 2 1-1 in the follow-up of patients treated surgically for non-small cell lung cancer in order to predict the risk of tumour recurrence. Serum levels of CYFRA 21-1 were measured using an immunoradiometric assay (C IS bio) in 57 patients with operable non-small cell lung cancer (NSCLC ): 25 with squamous cell carcinoma (SqCC), 20 with adenocarcinoma (AC) , 12 with large cell carcinoma (LCC) and 30 with nonmalignant lung dis eases. Elevated preoperative CYFRA 21-1 levels were identified in 44% of all patients with NSCLC, The diagnostic specificity of the assay wa s 97%. Positive CYFRA 21-1 levels was observed in 30% of stage I, 33% of stage II, and 55% of stage IIIa. Statistically significant differen ces were obtained between stages I and IIIa, II and ma, but not betwee n stages I and II. During follow-up recurrence was observed in 19 of 5 7 (33%) SCLC patients, Recurrence-free survival probability for patien ts with elevated serum CYFRA 21-1 levels before surgery was 52% (13/25 ), versus 81% (26/32) for patients with normal serum CYFRA 21-1 levels (p<0.01), In 15 patients with increased trend for CYFRA. 21-1, elevat ed serum CYFRA 21-1 levels preceded (13 patients) or coincided (2 pati ents) with the clinical detection of tumour recurrence, providing a pr edictive value of an increased trend of 87%. In the multivariate analy sis the association of the increase of CYFRA 21-1 level with a higher risk of recurrence is statistically significant (p<0.001). Our results indicate that serial determination of CYFRA 21-1 may be of value in a ssessing the efficacy to surgical treatment of patients with NSCLC.