Changes of serum cytokeratin 19 fragment in postoperative patients with non-small cell lung cancer

Objective To study the clinical value of serum cytokeratin 19 fragment (CYFRA21-1) as a biomarker in evaluating its prognosis,monitoring and follow-up of the postoperative patients with non- small cell lung cancer (NSCLC).Methods Serum CYFRA21-1 was determined by radioimmunoassay for 207 patients with NSCLC before and after surgical operation at Tongji Hospital,Shanghai.Relationship between serum CYFRA21-1 and the prognosis,recurrence and metastasis of lung cancer was analyzed retrospectively.Results The patients were followed-up for 37 months in average.Preoperative serum CYFRA21-1 was positive in 42.0% (87/207) of all the cases,48.8% (60/123) of squamous cell earcinama and 34.6% (27/78) of adenocarcinoma,with statistical significance (X~2=3.901,P0.05). Survival for those with negative serum CYFRA21-1 was better than those with positive serum CYFRA21-1 (P 0.05),whether in all patients,or in patients at stage Ⅱ or stage Ⅲ.Sensitivity and specificity of serum CYFRA21-1 determination were 52.9% (54/102) and 91.4% (96/105),respectively in those patients with recurrent positive or persistent positive of serum CYFRA21-1 during their 27-months follow-up after surgical operation.But,its sensitivity and specificity were 81.3% (39/48) and 84.6% (33/39), respectively in those with positive serum CYFRA21-1 before surgical operation.Conclusions Prognosis in patients with positive serum CYFRA21-1 before surgical operation was poorer than those with negative serum CYFRA21-1.Serum CYFRA21-1 can be used as a monitoring biomarker to evaluate recurrence or metastasis in patients with NSCLC.