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Additional diagnostic value of tumor markers in cytological fluid for diagnosis of non-small-cell lung cancer

Authors
 Jin Hur  ;  Hye-Jeong Lee  ;  Ji Eun Nam  ;  Young Jin Kim  ;  Yoo Jin Hong  ;  Hee Yeong Kim  ;  Se Kyu Kim  ;  Joon Chang  ;  Joo-Hang Kim  ;  Kyung Young Chung  ;  Hye Sun Lee  ;  Byoung Wook Choi 
Citation
 BMC CANCER, Vol.12 : 392, 2012 
Journal Title
 BMC CANCER 
Issue Date
2012
MeSH
Aged ; Antigens, Neoplasm/blood ; Antigens, Neoplasm/metabolism ; Biomarkers, Tumor/blood ; Biomarkers, Tumor/metabolism* ; Biopsy, Needle ; Carcinoembryonic Antigen/blood ; Carcinoembryonic Antigen/metabolism ; Carcinoma, Non-Small-Cell Lung/diagnosis* ; Carcinoma, Non-Small-Cell Lung/metabolism ; Carcinoma, Non-Small-Cell Lung/pathology ; Extracellular Fluid/metabolism* ; Female ; Humans ; Keratin-19/blood ; Keratin-19/metabolism ; Lung Neoplasms/diagnosis* ; Lung Neoplasms/metabolism ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Neoplasm Staging ; ROC Curve ; Reproducibility of Results ; Serpins/blood ; Serpins/metabolism
Keywords
Cytokeratin 19 fragments (CYFRA 21–1) ; Carcinoembryonic antigen (CEA) ; Squamous cell carcinoma antigen (SCC) ; Needle aspiration biopsy (NAB) ; Tumor marker ; Cytological fluid ; Non-small cell lung cancer (NSCLC)
Abstract
BACKGROUND: Cytological fluid from a needle aspiration biopsy (NAB) is obtained directly from tumor tissue, therefore many biomarker candidates will be present in high concentrations. The aim of this study was to prospectively assess and validate the tumor markers CYFRA 21-1, CEA, and SCC in cytological fluid obtained from NAB samples to determine if they improved the performance of NAB for diagnosing non-small cell lung cancer (NSCLC). METHODS: A total of 194 patients (M:F = 128:66, mean age 63.7 years) with suspected malignant pulmonary lesions were prospectively enrolled and underwent percutaneous NAB. Levels of CYFRA 21-1, CEA, and SCC were measured by immunoassay in serum and cytological fluid obtained during aspiration biopsy. Cut-off values to determined malignancy were 3.3 ng/mL in serum and 15.7 ng/mL in cytological fluid for CYFRA 21-1, 5 ng/mL and 0.6 ng/mL for CEA, and 2 ng/mL and 0.86 ng/mL for SCC. RESULTS: Of 194 patients, 139 patients (71.6%) had NSCLC and 55 (28.4%) had benign lesions. Sensitivity increased significantly for NAB combined with cytological tumor markers compared with NAB alone (CYFRA 21-1: 95% versus 83.5%, p < 0.001, CEA: 92.1% versus 83.5%, p = 0.002, SCC: 91.4% versus 83.5%, p = 0.003). Accuracy improved significantly for NAB combined with cytological CYFRA 21-1 compared with NAB alone (95.9% versus 88.1%, p < 0.001). The area under curve (AUC) of NAB with cytological CYFRA 21-1 was significantly larger than for NAB alone (0.966 versus 0.917, p = 0.009). CONCLUSION: Of the tested tumor markers, cytological fluid measurements of CYFRA 21-1 improved the diagnostic performance of NAB for NSCLC.
Files in This Item:
T201203817.pdf Download
DOI
22954172
Appears in Collections:
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Kyu(김세규)
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Joo Hang(김주항)
Kim, Hee Yeong(김희영)
Nam, Ji Eun(남지은)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Chung, Kyung Young(정경영)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89776
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