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To evaluate the diagnostic value of the serum cytokeratin 19 fragment (CYFRA 21-1) and compare it with carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) in lung cancer, we investigated the sera of 161 patients (58 with benign pulmonary disease and 103 with lung cancer) using immunoradiometric assay Sensitivities for CYFRA 21-1, CEA and TPA (using 3.5 ng/ml, 5.0 ng/ml, 110 U/I, respectively, cut-off va1ues) in lung cancer were 64%, 47%, and 61%, respectively. Positive CYFRA 21-1 levels were identified in 75% of patients with squamous cell carcinoma (n = 36), in 67% with adenocarcinoma (n = 45), in 17% with large cell carcinoma (n = 6), and in 50% with small cell lung cancer (SCLC) (n = 16). However, CYFRA 21-1 levels were not significantly different between squamous cell carcinoma and the other histological types. Sensitivity of the CYFRA 21-l and/or CEA combination (77%), CEA and/or TPA combination (77%), and CYFRA 21-1 and/or CEA and/or TPA combination (82%) were significantly higher than that of single CYFRA 21-1 masurement Elevated CYFRA 21-l levels were observed in 44% of stage I and II (n = 18) and 72% of stage III and IV (n = 69) patients with non-small cell lung cancer (p = 103, r = 0.448, P 0.0001), but not between CYFRA 21-1 and CEA (n = 103, r = 0.025, p = 0.8), nor between CEA and TPA (n = 103, r = 0.082, p = 0.41). Our results indicate that CYFRA 21-1 may be a useful tumor marker in hung cancer. The CYFRA 21-1 and/or CEA combination could be recommended as the best combination for increasing the diagnostic sensitivity. In addition, CYFRA 21-1 may contribute to the monitoring of lung cancer. |
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