DIAGNOSTIC AND PROGNOSTIC VALUE OF CYFRA-21-1 COMPARED WITH OTHER TUMOR-MARKERS IN PATIENTS WITH NONSMALL CELL LUNG-CANCER - A PROSPECTIVE-STUDY OF 116 PATIENTS

The diagnostic value of Cyfra 21-1 in non-small lung cancer (NSCLC) ha s been established, but few studies have focused on its prognostic val ue. The aim of this study was to compare that of carcinoembryonic anti gen (CEA), carbohydrate antigen (CA) 19-9, CA 125, neuron-specific eno lase and squamous cell carcinoma antigen. 116 patients with unresectab le (n = 88) or resectable (n = 28) NSCLC were prospectively monitored from diagnosis, for a median of 14.4 months. All; patients underwent t umour-marker determinations before treatment, then every 3 months. The ir diagnostic value was studied using ROC (receiver operating characte ristic) curves, based on control measure in 23 patients with benign lu ng diseases. The prognostic analysis was based on overall survival as the main endpoint. The diagnostic value of Cyfra 21-1 was confirmed, w ith a sensitivity of 54% and a specificity of 96% at a cut-off value o f 3.3 ng/ml. At diagnosis, in the 88 non-surgical NSCLC, besides the p resence of metastases (P = 0.017), Cyfra 21-1 (P = 0.017) and CA 125 ( P = 0.03) were related to outcome. Elevated levels of Cyfra 21-1 at an y time during the disease course was selected by multivariate analysis as additional predictors of poor survival. (C) 1997 Elsevier Science Ltd.