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

Hur J, Lee HJ, Nam JE, Kim YJ, Hong YJ, Kim HY, Kim SK, Chang J, Kim JH, Chung KY, Lee HS, Choi BW - BMC Cancer (2012)

Bottom Line: Levels of CYFRA 21-1, CEA, and SCC were measured by immunoassay in serum and cytological fluid obtained during aspiration biopsy.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).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

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.

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Receiver operating characteristics (ROC) curves. (a) ROC curves for NAB combined with CYFRA 21–1, CEA and SCC in the serum and NAB alone. (b) ROC curves for NAB combined with CYFRA 21–1, CEA and SCC in the cytological fluid and NAB alone.
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Figure 2: Receiver operating characteristics (ROC) curves. (a) ROC curves for NAB combined with CYFRA 21–1, CEA and SCC in the serum and NAB alone. (b) ROC curves for NAB combined with CYFRA 21–1, CEA and SCC in the cytological fluid and NAB alone.

Mentions: For diagnosis of NSCLC, the AUC of NAB with serum CEA and SCC was not significantly larger than the AUC of NAB alone (p = 0.408, and p = 0.207, respectively). The AUC of NAB with serum CYFRA 21–1 decreased significantly compared with the AUC of NAB alone (p = 0.009). Using the cytological tumor markers, the AUC of NAB with cytological CYFRA 21–1 was significantly larger than the AUC of NAB alone (0.966 versus 0.917, p = 0.009). However, the AUC of NAB with cytological CEA was not significantly larger than the AUC of NAB alone (p = 0.999). The AUC of NAB with cytological SCC decreased significantly compared with the AUC of NAB alone (p = 0.003) (Table 4) (Figure 2).


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

Hur J, Lee HJ, Nam JE, Kim YJ, Hong YJ, Kim HY, Kim SK, Chang J, Kim JH, Chung KY, Lee HS, Choi BW - BMC Cancer (2012)

Receiver operating characteristics (ROC) curves. (a) ROC curves for NAB combined with CYFRA 21–1, CEA and SCC in the serum and NAB alone. (b) ROC curves for NAB combined with CYFRA 21–1, CEA and SCC in the cytological fluid and NAB alone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475052&req=5

Figure 2: Receiver operating characteristics (ROC) curves. (a) ROC curves for NAB combined with CYFRA 21–1, CEA and SCC in the serum and NAB alone. (b) ROC curves for NAB combined with CYFRA 21–1, CEA and SCC in the cytological fluid and NAB alone.
Mentions: For diagnosis of NSCLC, the AUC of NAB with serum CEA and SCC was not significantly larger than the AUC of NAB alone (p = 0.408, and p = 0.207, respectively). The AUC of NAB with serum CYFRA 21–1 decreased significantly compared with the AUC of NAB alone (p = 0.009). Using the cytological tumor markers, the AUC of NAB with cytological CYFRA 21–1 was significantly larger than the AUC of NAB alone (0.966 versus 0.917, p = 0.009). However, the AUC of NAB with cytological CEA was not significantly larger than the AUC of NAB alone (p = 0.999). The AUC of NAB with cytological SCC decreased significantly compared with the AUC of NAB alone (p = 0.003) (Table 4) (Figure 2).

Bottom Line: Levels of CYFRA 21-1, CEA, and SCC were measured by immunoassay in serum and cytological fluid obtained during aspiration biopsy.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).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

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.

Show MeSH
Related in: MedlinePlus