Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Acta Med Indones. 2020 Apr;52(2):140-146.
non-small cell lung carcinoma (NSCLC) is the most common type of lung cancer. Therefore, research into its prognostic factor is very important for better patient management. However, there have been no studies looking for the association of CYFRA 21-1 and CEA with survival of NSCLC in Indonesia, and no cut-off value for them as standardized prognostic factors. This study aims to know the association of CEA and CYFRA 21-1 with one-year survival of advanced stage NSCLC in RSCM and determining their cut-off point as a prognostic factor.
a retrospective cohort study of 111 subjects with advanced stage NSCLC aged > 18 years who were diagnosed from January 2012 to May 2018, resulted in a set of data which includes an initial score of CEA and CYFRA 21-1 at diagnosis, along with their confounding factors, namely performance status (PS), type of histology, therapy, and stadium. All data were taken from the RSCM Medical Record Unit.
the CEA area under the curve (AUC) was less than 50% (AUC=0.446) and not significant, whereas AUC CYFRA 21-1=0.741 (0.636-0.847) with p <0.001 was significant in this analysis. CYFRA 21-1 cut-off point was > 10.9 ng / mL with a sensitivity of 69.5% and specificity of 65.5%. The variables that met the proportional hazard assumption were CYFRA 21-1, PS, histology, and therapy. CYFRA 21-1 > 10.9 ng/mL had HR 1.744 (HR=1.744; p=0.028); ECOG 3-4 PS had HR 2.434 (HR=2.434; p=0.026); non-adenocarcinoma histology had HR 1.929 (HR=1.929; p=0.029); and the non-chemotherapy group had HR 2.633 (HR=2.633; p=2.633; p=0.015).
from both tumour markers, only CYFRA 21-1 was proven to be significant to NSCLC survival. CYFRA 21-1 cut-off value as a prognostic factor was > 10.9 ng/mL.
非小细胞肺癌（NSCLC）是最常见的肺癌类型。因此，研究其预后因素对于更好地管理患者非常重要。然而，在印度尼西亚，还没有研究寻找 CYFRA 21-1 和 CEA 与 NSCLC 生存的相关性，也没有将它们作为标准化预后因素的截断值。本研究旨在了解 CEA 和 CYFRA 21-1 与 RSCM 晚期 NSCLC 患者一年生存率的相关性，并确定其作为预后因素的截断值。
这是一项回顾性队列研究，纳入了 111 名年龄>18 岁的晚期 NSCLC 患者，这些患者于 2012 年 1 月至 2018 年 5 月在 RSCM 诊断，得出了一组数据，其中包括诊断时 CEA 和 CYFRA 21-1 的初始评分，以及他们的混杂因素，即表现状态（PS）、组织学类型、治疗和分期。所有数据均来自 RSCM 病历单位。
CEA 的曲线下面积（AUC）小于 50%（AUC=0.446）且无统计学意义，而 CYFRA 21-1 的 AUC=0.741（0.636-0.847）具有统计学意义（p<0.001）。CYFRA 21-1 的截断值为>10.9ng/mL，其灵敏度为 69.5%，特异性为 65.5%。符合比例风险假设的变量为 CYFRA 21-1、PS、组织学和治疗。CYFRA 21-1>10.9ng/mL 的 HR 为 1.744（HR=1.744；p=0.028）；ECOG PS 3-4 的 HR 为 2.434（HR=2.434；p=0.026）；非腺癌组织学的 HR 为 1.929（HR=1.929；p=0.029）；非化疗组的 HR 为 2.633（HR=2.633；p=0.015）。
在这两个肿瘤标志物中，只有 CYFRA 21-1 被证明与 NSCLC 的生存有关。CYFRA 21-1 截断值作为预后因素>10.9ng/mL。
