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Analysis of tumor markers in the cytological fluid obtained from computed tomography-guided needle aspiration biopsy for the diagnosis of non-small cell lung cancer

 Hong, Yoo Jin  ;  Hur, Jin  ;  Lee, Hye-Jeong  ;  Nam, Ji Eun  ;  Kim, Young Jin  ;  Kim, Hua Sun  ;  Kim, Hee Yeong  ;  Kim, Se Kyu  ;  Chang, Joon  ;  Kim, Joo-Hang  ;  Chung, Kyung Young  ;  Choi, Byoung Wook  ;  Choe, Kyu Ok 
 JOURNAL OF THORACIC ONCOLOGY, Vol.6(8) : 1330-1335, 2011 
Journal Title
Issue Date
Adenocarcinoma/diagnosis ; Adenocarcinoma/metabolism ; Adult ; Aged ; Aged, 80 and over ; Antigens, Neoplasm/metabolism ; Biomarkers, Tumor/metabolism* ; Biopsy, Fine-Needle ; Carcinoembryonic Antigen/metabolism ; Carcinoma, Large Cell/diagnosis ; Carcinoma, Large Cell/metabolism ; Carcinoma, Non-Small-Cell Lung/diagnosis* ; Carcinoma, Non-Small-Cell Lung/metabolism* ; Carcinoma, Squamous Cell/diagnosis ; Carcinoma, Squamous Cell/metabolism ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Immunoradiometric Assay ; Keratin-19/metabolism ; Lung Neoplasms/diagnosis* ; Lung Neoplasms/metabolism* ; Male ; Middle Aged ; Neoplasm Staging ; Nuclear Proteins/metabolism ; Phosphoproteins/metabolism ; Prognosis ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Serpins/metabolism ; Survival Rate ; Tomography, X-Ray Computed*
CYFRA 21-1 ; CEA ; SCC-Ag ; Tumor marker ; Cytological fluid ; CT-guided needle aspiration biopsy (NAB)
PURPOSE: The aim of this study was to prospectively assess whether analysis of the tumor markers cytokeratin 19 fragments (CYFRA 21-1), carcinoembryonic antigen (CEA), and squamous cell carcinoma (SCC) antigen in cytological fluid can improve the performance of computed tomography (CT)-guided needle aspiration biopsy (NAB) in the diagnosis of non-small cell lung cancer (NSCLC). METHODS: A total of 100 patients (men:women = 41:59, mean age: 63 years) with suspected malignant pulmonary lesions were prospectively enrolled for CT-guided NAB procedures. Levels of CYFRA 21-1, CEA, and SCC in the cytological fluid were measured by immunoradiometric assays. The cutoff value for tumor markers was selected on the basis of best accuracy through receiver operating characteristic curves. The sensitivity and areas under the curve (AUC) of NAB alone were compared with those of NAB combined with cytological tumor markers (CYFRA 21-1, CEA, and SCC). RESULTS: Among 100 patients, 71 (71%) had NSCLC and 29 (29%) had benign lesions. The sensitivity, specificity, and accuracy for diagnosing NSCLC were 85.7%, 100%, and 89%, respectively, for NAB alone. The sensitivity increased significantly for NAB combined with a tumor marker compared with NAB alone (100% for CYFRA 21-1, 92.9% for CEA, and 94.2% for SCC; p = 0.001, p = 0.025, and p = 0.014, respectively). The AUC of NAB with CYFRA 21-1 was significantly larger than the AUC of NAB alone (p = 0.001). CONCLUSION: Evaluation of tumor markers CYFRA 21-1, CEA, and SCC in the cytological fluid can improve the diagnostic performance of CT-guided NAB for NSCLC. Of these markers, CYFRA 21-1 is the most useful cytological tumor marker.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 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
Yonsei Authors
Kim, Se Kyu(김세규)
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Joo Hang(김주항)
Kim, Hua Sun(김화선)
Kim, Hee Yeong(김희영)
Nam, Ji Eun(남지은)
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)
Choe, Kyu Ok(최규옥)
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
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