Decreased levels of serum cytokeratin 19 fragment CYFRA 21‑1 predict objective response to chemotherapy in patients with non-small cell lung cancer

Pang,Li; Wang,Jing; Jiang,Yanwen; Chen,Liangan

doi:10.3892/etm.2013.1171

Decreased levels of serum cytokeratin 19 fragment CYFRA 21‑1 predict objective response to chemotherapy in patients with non-small cell lung cancer

Authors:
- Li Pang
- Jing Wang
- Yanwen Jiang
- Liangan Chen
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Affiliations: Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing 100853, P.R. China, Department of Pulmonary and Critical Care Medicine, Beijing Shijitan Hospital, Beijing 100050, P.R. China
Published online on: June 20, 2013 https://doi.org/10.3892/etm.2013.1171
Pages: 355-360

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Abstract

Diagnostic tools capable of predicting early responses to chemotherapy are required to improve the individual management of cancer patients. The present study aimed to evaluate the prognostic significance of the serum tumor markers CYFRA 21-1, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), carbohydrate antigen (CA) 125, and CA 19-9 for predicting responses to different chemotherapy regimens in patients with non-small cell lung cancer (NSCLC). A total of 276 patients with postoperative stage I-IV NSCLC were retrospectively reviewed. The five tumor markers were measured before and after at least two cycles of chemotherapy using an electrochemiluminescent assay. Multivariate analysis revealed that performance status, age, postoperative stage and surgery were significantly associated with the response to chemotherapy. High baseline CYFRA 21-1 and CA 19-9 levels were associated with poor effectiveness of chemotherapy. Significant reductions in CYFRA 21-1 levels were associated with a positive response to various chemotherapy regimens. CEA, CA 125 and CA 19-9 expression was only associated with a positive response in patients receiving paclitaxel, docetaxel, pemetrexed and the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). NSE expression was only associated with a positive response to gemcitabine. Receiver operating characteristic (ROC) curve analysis indicated that CYFRA 21-1 is the most sensitive of the tumor markers in predicting the response to chemotherapy. Serum CYFRA 21-1 is a useful surrogate marker for predicting the response to different chemotherapy regimens used to treat NSCLC and is a more sensitive marker than CEA, CA125, CA19-9 and NSE.

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