P. Stieber et al., CYFRA 21-1 in the early diagnosis of recurrent disease in non small cell lung carcinomas (NSCLC), ANTICANC R, 19(4A), 1999, pp. 2665-2668
Due to its high specificity and sensitivity CYFRA 21-1 was found to be the
leading marker in NSCLC. We focused our interest on the diagnostic value of
CYFRA 21-1 in the detection of recurrent disease of 86 patients suffering
from NSCLC following RO-resection (median follow up: 22.7 months). Preopera
tively, CYFRA 21-1 was positive (cut off 3.3 ng/mL) in 38 of the 86 patient
s (45%). 48 hours after surgery all 38 patients had CYFRA 21-1-concentratio
ns within the reference range corresponding to a RO-resection. During furth
er follow up 22 of these patients developed local recurrence and / or dista
nt metastases. All 22 patients showed elevated CYFRA 21-1-values at time of
detection of relapse, in 8 patients the CYFRA 21-1-increase preceeded the
detection of recurrence by 2 to 15 months 16 patients remained disease free
and had stable low CYFRA 21-1-values all the time. Out of the 48 preoperat
ively CYFRA 21-1-negative patients 15 developed recurrent disease. 7 of the
15 patients proved to express cytokeratin 19-fragments at this time. Concl
usion: CYFRA 21-1 possesses a high specificity and sensitivity in the detec
tion of recurrent disease of patients suffering from NSCLC and with elevate
d values at time of primary diagnosis. Thus CYFRA 21-1 could contribute to
an economical follow up care. Even if there is nor the possibility of curat
ive therapy at time of relapse the early use of systemic therapy could be c
onsidered.