Cytokeratins as serum markers in lung cancer: A comparison of CYFRA 21-1 and TPS

被引:76
作者
Pujol, JL
Grenier, J
Parrat, E
Lehmann, M
Lafontaine, T
Quantin, X
Michel, FB
机构
[1] CTR VAL AURELLE, INST CANC, MONTPELLIER, FRANCE
[2] HOP GASTON DOUMERGUE, DEPT CHEST DIS, NIMES, FRANCE
[3] HOP GASTON DOUMERGUE, DEPT BIOSTAT, NIMES, FRANCE
关键词
D O I
10.1164/ajrccm.154.3.8810612
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
We examined two recently described cytokeratin markers, CYFRA 21-1 (cytokeratin fragment recognized by KS 19-1 and BM 19-21 antibodies) and TPS (specific M3 epitope of the tissue polypeptide antigen), in 405 lung cancer patients (91 small-cell and 314 non-small-cell lung cancers) and 59 patients presenting with nonmalignant pulmonary disease. Sensitivity-specificity relationship, as analyzed by receiver operating characteristic curves, demonstrated a higher accuracy of CYFRA 21-1 in comparison with TPS in both small-cell and non-small-cell lung cancers. Thresholds of 3.6 ng/ml and 140 U/L for CYFRA 21-1 and TPS respectively gave a 90% to 95% specificity. Sensitivity of CYFRA 21-1 was the highest in squamous-cell carcinomas (0.61) and the lowest in small-cell lung cancers (0.36), whereas sensitivity of TPS did not vary significantly according to histology (overall sensitivity, 0.40). In nonsmall-cell lung cancers, both serum CYFRA 21-1 and serum TPS distributions varied significantly according to Mountain's stage of the disease, nodal status, tumor status, and performance status, inasmuch as the worse each above-mentioned variable became, the higher the median and interquartile serum marker level was. Neither CYFRA 21-1 nor TPS was able to accurately discriminate between stage IIIa (marginally resectable) and stage IIIb (unresectable) non-small-cell lung cancers, however. In both small-cell and non-small-cell lung cancers, univariate survival analyses demonstrated that either a CYFRA 21-1 level over 3.6 ng/ml or a TPS level over 140 U/L significantly indicated a poor survival rate. In the whole population, taking into account other significant variables, Cox's model analysis demonstrated that a poor performance index, an advanced stage of the disease, the presence of metastases, elevated serum lactate dehydrogenase, and high serum CYFRA 21-1 (odds ratio, 1.74; 95% confidence interval, [1.33-2.27]) were independent prognostic variables. We concluded that CYFRA 21-1 is a significant determinant of survival. Other applications of cytokeratin markers in lung cancer are still limited.
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页码:725 / 733
页数:9
相关论文
共 38 条
[1]  
[Anonymous], 1982, AM J CLIN PATHOL, V77, P123
[2]  
BJORKLUND B, 1992, TUMORDIAGN THER, V13, P78
[3]  
BJORKLUND B, 1987, HUMAN TUMOR MARKERS, P169
[4]   CYTOKERATINS IN NORMAL LUNG AND LUNG CARCINOMAS .1. ADENOCARCINOMAS, SQUAMOUS-CELL CARCINOMAS AND CULTURED-CELL LINES [J].
BLOBEL, GA ;
MOLL, R ;
FRANKE, WW ;
VOGTMOYKOPF, I .
VIRCHOWS ARCHIV B-CELL PATHOLOGY INCLUDING MOLECULAR PATHOLOGY, 1984, 45 (04) :407-429
[5]  
BROERS JLV, 1987, CANCER RES, V47, P3225
[6]   USEFULNESS OF TISSUE POLYPEPTIDE ANTIGEN IN STAGING, MONITORING, AND PROGNOSIS OF LUNG-CANCER [J].
BUCCHERI, G ;
FERRIGNO, D .
CHEST, 1988, 93 (03) :565-570
[7]  
BUCCHERI GF, 1986, CANCER, V57, P2389, DOI 10.1002/1097-0142(19860615)57:12<2389::AID-CNCR2820571225>3.0.CO
[8]  
2-#
[9]  
COX DR, 1972, J R STAT SOC B, V34, P187
[10]  
COX JD, 1981, YALE J BIOL MED, V54, P201