Niklinski J, Furman M, Rapellino M, Chyczewski L, Laudanski J, Oliaro A, Ruffini E
Department of Thoracic Surgery, Medical School, Bialystok, Poland.
J Cardiovasc Surg (Torino). 1995 Oct;36(5):501-4.
The aim of this study was to evaluate serial determinations of CYFRA 21-1 in the follow-up of patients treated surgically for non-small cell lung cancer in order to predict the risk of tumour recurrence. Serum levels of CYFRA 21-1 were measured using an immunoradiometric assay (CIS bio) in 57 patients with operable non-small cell lung cancer (NSCLC): 25 with squamous cell carcinoma (SqCC), 20 with adenocarcinoma (AC), 12 with large cell carcinoma (LCC) and 30 with non-malignant lung diseases. Elevated preoperative CYFRA 21-1 levels were identified in 44% of all patients with NSCLC. The diagnostic specificity of the assay was 97%. Positive CYFRA 21-1 levels was observed in 30% of stage I, 33% of stage II, and 55% of stage IIIa. Statistically significant differences were obtained between stages I and IIIa, II and IIIa, but not between stages I and II. During follow-up recurrence was observed in 19 of 57 (33%) NSCLC patients. Recurrence-free survival probability for patients with elevated serum CYFRA 21-1 levels before surgery was 52% (13/25), versus 81% (26/32) for patients with normal serum CYFRA 21-1 levels (p < 0.01). In 15 patients with increased trend for CYFRA 21-1, elevated serum CYFRA 21-1 levels preceded (13 patients) or coincided (2 patients) with the clinical detection of tumour recurrence, providing a predictive value of an increased trend of 87%. In the multivariate analysis the association of the increase of CYFRA 21-1 level with a higher risk of recurrence is statistically significant (p < 0.001).
本研究的目的是评估在接受手术治疗的非小细胞肺癌患者随访过程中连续测定细胞角蛋白19片段（CYFRA 21-1），以预测肿瘤复发风险。采用免疫放射分析（CIS bio）法检测了57例可手术切除的非小细胞肺癌（NSCLC）患者的血清CYFRA 21-1水平：25例鳞状细胞癌（SqCC）、20例腺癌（AC）、12例大细胞癌（LCC）以及30例非恶性肺部疾病患者。所有NSCLC患者中44%术前CYFRA 21-1水平升高。该检测方法的诊断特异性为97%。I期患者中30%、II期患者中33%以及IIIA期患者中55%的CYFRA 21-1水平呈阳性。I期与IIIA期、II期与IIIA期之间差异有统计学意义，但I期与II期之间无差异。随访期间，57例NSCLC患者中有19例（33%）出现复发。术前血清CYFRA 21-1水平升高的患者无复发生存概率为52%（13/25），而血清CYFRA 21-1水平正常的患者为81%（26/32）（p<0.01）。在15例CYFRA 21-1呈上升趋势的患者中，血清CYFRA 21-1水平在肿瘤复发临床检测之前（13例患者）或同时出现（2例患者），上升趋势的预测价值为87%。多因素分析显示，CYFRA 21-1水平升高与较高的复发风险之间的关联具有统计学意义（p<0.001）。
