Preoperative CYFRA 21-1 level as a prognostic indicator in resected nonsmall cell lung cancer

Cytokeratin 19 is particularly abundant in carcinoma of the lung, The CYFRA 21-1 assay has recently been developed for detection of a cytokeratin 19 f ragment in serum, Zn the current study, the prognostic information provided by the CYFRA 21-1 assay in operable nonsmall cell lung cancer (NSCLC) was analysed, Serum levels of CVI;RA 21-1 were measured using an immunoradiometric assay (DiaSorin) in 94 patients with operable NSCLC, Survival and disease-free su rvival curves related to initial levels of this marker were estimated using the Kaplan-Meier method, Elevated preoperativte CYFRA 21-1 levels were identified in 42% of patients with NSCLC, The number of patients with elevated levels of this marker inc reased with tumour node metastasis (TNM) stage (p=0.02), In univariate anal ysis elevated levels of CYFRA 21-1 were significantly associated with poor overall survival (p<0.001) and with disease-free survival (p<0.001). The re sults remained significant when the comparisons were adjusted, using the st ratified log-rank test, for patient's TNM stage (p<0.001 for both overall a nd disease-free survival), Elevated preoperative levels of CYFRA 21-1 decre ased the probability of survival or surviving without recurrence 15 months or more after the operation. This was confirmed by the results of the multi variate analysis. In conclusion, CYFRA 21-1 may he an independent prognostic parameter of sur vival and tumour relapse in nonsmall cell lung cancer and may be useful in identifying resected cancer patients It high risk for treatment failure.