Dhanurdhar Yera, Jagaty Suman Kumar, Subhankar Saswat, Behera Debasis
Department of Respiratory Medicine, Hi-Tech Medical College, Bhubaneswar, Odisha, India.
Department of Respiratory Medicine, KIMS, Bhubaneswar, Odisha, India.
Int J Appl Basic Med Res. 2023 Apr-Jun;13(2):89-94. doi: 10.4103/ijabmr.ijabmr_639_22. Epub 2023 Jul 17.
Bronchogenic carcinoma is a leading cause of cancer-related death in men and women. Early diagnosis and treatment in these cases are essential for a better prognosis. Serum biomarkers such as serum amyloid A (SAA) and CYFRA 21-1 have generated encouraging results regarding their use in the diagnosis of these cases but data on their role in the Indian scenario are still lacking.
The study aims to measure the levels of SAA and CYFRA 21-1 in various types of lung cancer and compare them with patients without lung cancer. It also aims to compare the values of these biomarkers before and after chemotherapy and correlate them with response to treatment.
It was a prospective, case-control study conducted in the Department of Pulmonary Medicine, Government Medical College, Chandigarh. All histologically and/or cytologically proven lung cancer cases were included in the study group while patients with diseases other than lung cancer formed the control group. All patients were evaluated through a complete history and thorough clinical examination. Measurement of SAA and CYFRA 21-1 in blood was done by sandwich ELISA method. The patients in the study group were followed up regularly and the biomarkers were measured again after four cycles of chemotherapy. The response of tumors to chemotherapy was evaluated as per modified Response Evaluation Criteria in Solid Tumors criteria. The statistical analysis was carried out using SPSS version 19.0.
The study group and control group included 20 patients each. Hoarseness of voice and hemoptysis were significantly associated with lung cancer patients ( = 0.001 and = 0.025, respectively). Serum levels above 8745 ng/ml for SAA and 2.55 ng/ml for serum CYFRA 21-1 were used as diagnostic biomarker in lung cancer. The serum levels of CYFRA 21-1 were found to be significantly raised in nonsmall cell carcinoma (NSCLC) in comparison to SCLC of lung. There was a statistically significant decrease in the serum levels of CYFRA 21-1 in lung cancer patients on C4 cycle of chemotherapy in comparison to C1 cycle ( = 0.014).
SAA and CYFRA 21-1 could be valuable diagnostic biomarkers in lung cancer. CYFRA 21-1, in addition, could also be used as prognostic biomarker in lung cancer patients undergoing chemotherapy as it showed significant decrease after C4-cycle of chemotherapy. It can also be a potential biomarker to differentiate small cell and NSCLC.
支气管肺癌是男性和女性癌症相关死亡的主要原因。这些病例的早期诊断和治疗对于更好的预后至关重要。血清生物标志物如血清淀粉样蛋白A（SAA）和细胞角蛋白片段21-1（CYFRA 21-1）在这些病例的诊断中取得了令人鼓舞的结果，但关于它们在印度情况下的作用的数据仍然缺乏。
本研究旨在测量各种类型肺癌中SAA和CYFRA 21-1的水平，并与无肺癌患者进行比较。它还旨在比较化疗前后这些生物标志物的值，并将它们与治疗反应相关联。
这是一项在昌迪加尔政府医学院肺病科进行的前瞻性病例对照研究。所有经组织学和/或细胞学证实的肺癌病例均纳入研究组，而患有非肺癌疾病的患者组成对照组。所有患者均通过完整的病史和全面的临床检查进行评估。采用夹心酶联免疫吸附测定法（ELISA）测定血液中的SAA和CYFRA 21-1。研究组患者定期随访，并在四个化疗周期后再次测量生物标志物。根据实体瘤改良反应评估标准评估肿瘤对化疗的反应。使用SPSS 19.0版进行统计分析。
研究组和对照组各包括20名患者。声音嘶哑和咯血与肺癌患者显著相关（分别为P = 0.001和P = 0.025）。SAA血清水平高于8745 ng/ml和血清CYFRA 21-1高于2.55 ng/ml被用作肺癌的诊断生物标志物。与肺小细胞肺癌（SCLC）相比，非小细胞肺癌（NSCLC）中CYFRA 21-1的血清水平显著升高。与化疗第1周期相比，肺癌患者化疗第4周期CYFRA 21-1的血清水平有统计学意义的下降（P = 0.014）。
SAA和CYFRA 21-1可能是肺癌中有价值的诊断生物标志物。此外，CYFRA 21-1还可作为接受化疗的肺癌患者的预后生物标志物，因为它在化疗第4周期后显著下降。它也可能是区分小细胞肺癌和非小细胞肺癌的潜在生物标志物。
