Skip to main content

Size, edge, and stage of NSCLC determine the release of CYFRA 21-1 in bloodstream

Summary

Background

The computed tomography (CT) is the “golden standard” for the assessment of lung cancer progression due to its ability to clearly display the radiomorphologic characteristics. As lung cancer mortality is very high, more comprehensive approaches may be needed for its earlier diagnosis. The research hypothesis was to investigate the relation between the CT morphologic characteristics (size, stage, and edges) of pulmonary lesion and the extent of release of a soluble fragment of cytokeratin 19 being a part of the cytoskeleton of lung epithelial cells.

Methods

This is a retrospective study including 246 pulmonary lesions being diagnosed and subsequently treated at the University Hospital Centre Zagreb, Croatia. The information about the relevant clinical, radiological, and laboratory facts was collected at the time of diagnosis in 164 NSCLC patients, 52 patients with pulmonary metastases, and 30 benign cysts. CYFRA 21-1 was determined by electrochemiluminescence immunoassay. The nonparametric statistical methods were applied.

Results

There was a positive correlation between the size and CYFRA 21-1 in NSCLC unlike metastases or cysts (p = 0.0001). The highest values of CYFRA 21-1 were seen in advanced stages of NSCLC and lesions with spiculated edges.

Conclusions

The level of CYFRA 21-1 positively correlates with the greatest size of NSCLC measured by CT. The differences in CYFRA 21-1 according to TNM classification are significant (p = 0.0001): higher values were observed in advanced stages and with tumors having spiculated, lobulated, and poorly defined edges. The combination of CYFRA 21-1 and CT may help articulate the malignancy of pulmonary lesions.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

References

  1. Globocan.iarc.fr (homepage on the internet). Lyon: International Agency for Research on Cancer; 2010 (accessed and cited 23 March 2012). www.globocan.iarc.fr.

  2. Hzjz.hr (homepage on the internet). Zagreb: Croatian Institute for Public Health. Croatian Cancer Registry (updated 12 October 2012, accessed and cited 25 October 2012). http://www.hzjz.hr/rak/novo.htm.

  3. Kent MS, Port JL, Altorki NK. Current state of imaging for lung cancer staging. Thorac Surg Clin. 2004;14:1–13.

    PubMed  Article  Google Scholar 

  4. Verschakelen JA, Bogaert J, De Wever W. Computed tomography in staging for lung cancer. Eur Respir J Suppl. 2002;35:40S–8S.

    CAS  PubMed  Article  Google Scholar 

  5. Schafer-Prokop C, Prokop M. New imaging techniques in the treatment guidelines for lung cancer. Eur Respir J. 2002;35(Suppl.):71S–83S.

  6. Verschakelen JA, De Wever W, Bogaert J, Stroobant S. Imaging: staging of lung cancer. Eur Respir Monogr. 2004;30:214–44.

    Google Scholar 

  7. Toloza EM, Harpole L, McCrory DC. Noninvasive staging of non-small cell lung cancer: a review of current evidence. Chest. 2003;123(1 Suppl.):137S–46S.

    PubMed  Article  Google Scholar 

  8. Hyer JD, Silvestri G. Diagnosis and staging of lung cancer. Clin Chest Med. 2000;21:95–106.

    CAS  PubMed  Article  Google Scholar 

  9. Goldstraw P. The 7th edition of TNM in lung cancer: what now? J Thoracic Oncol. 2009;4:671–3.

    Article  Google Scholar 

  10. Chen C, Bao F, Zheng H, Zhou YM, Bao MW, Xie HK, et al. Local extension at the hilum region is associated with worse long-term survival in stage I non-small cell lung cancers. Ann Thorac Surg. 2012;93:389–96.

    PubMed  Article  Google Scholar 

  11. Lee C, Byun C, Lee J, Kim D, Cho B, Chung K, et al. The prognostic factors of resected non-small cell lung cancer with chest wall invasion: a retrospective study. World J Surg Oncol. 2012;12:9.

    Article  Google Scholar 

  12. Neralic Meniga I, Kujundzic Tiljak M, Ivankovic D, Aleric I, Zekan M, Hrabac P, et al. Prognostic value of computed tomography morphologic characteristics in stage I non-small cell lung cancer. Clin Lung Cancer. 2010;11:98–104.

  13. Atance-León P, Moreno-Mata N, González-Aragoneses F, Canizares-Carretero MÁ, García-Jiménez MD, Genovés-Crespo M, et al. Multicenter analysis of survival and prognostic factors in pathologic stage I non-small cell lung cancer according to the new 2009 TNM classification. Arch Bronconeumol. 2011;47:441–6.

    Google Scholar 

  14. Brundage MD, Davies D, Mackillop WJ. Prognostic factors in non-small cell lung cancer: a decade of progress. Chest. 2002;122:1037–57.

    PubMed  Article  Google Scholar 

  15. Pujol JL, Boher JM, Grenier J, Quantin X. CYFRA 21-1, neuron-specific enolase and prognosis of non-small cell lung cancer: prospective study in 621 patients. Lung Cancer. 2001;31:221–31.

    CAS  PubMed  Article  Google Scholar 

  16. Molina R, Filella X, Augé JM, Fuentes R, Bover I, Rifa J, et al. Tumor markers (CEA, CA 125, CYFRA 21-1, SCC and NSE) in patients with non-small cell lung cancer as an aid in histological diagnosis and prognosis. Comparison with the main clinical and pathological prognostic factors. Tumor Biol. 2003;24:209–18.

    CAS  Article  Google Scholar 

  17. WMA Declaration of Helsinki. Ethical principles for medical research involving human subjects (Internet, accessed and cited 28 May 2013). http://www.wma.net/en/30publications/10policies/b3/.

  18. Silvestri GA, Lenz JE, Harper SN, et al. The relationship of clinical findings to CT scan evidence of adrenal gland metastases in the staging of bronchogenic carcinoma. Chest. 1992;102:1748–51.

    CAS  PubMed  Article  Google Scholar 

  19. Pope RJE, Hansell DM. Extra-thoracic staging of lung cancer. Eur J Radiol. 2003;45:31–8.

    PubMed  Article  Google Scholar 

  20. Moll R, Franke WW, Schiller D, Geiger B, Krepler R. The catalogue of human cytokeratins: patterns of expression in normal epithelia, tumors and cultured cells. Cell. 1982;31:11–24.

    CAS  PubMed  Article  Google Scholar 

  21. Moll R, Divo M, Langbein L. The human keratins: biology and pathology. Histochem Cell Biol. 2008;129:705–33.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  22. Aktogu S, Yuncu G, Halilcolar H, Ermete S, Buduneli T. Bronchogenic cysts: clinicopathological presentation and treatment. Eur Respir J. 1996;9:2017–21.

    CAS  PubMed  Article  Google Scholar 

  23. McAdams HP, Kirejczyk WM, Rosado-de-Christenson ML, Matsumoto S. Bronchogenic cyst: features with clinical and histopathologic correlation. Radiology. 2000;217:441–6.

    CAS  PubMed  Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ana Franjević PhD.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sertić Milić, H., Franjević, A., Bubanović, G. et al. Size, edge, and stage of NSCLC determine the release of CYFRA 21-1 in bloodstream. Wien Klin Wochenschr 127, 465–471 (2015). https://doi.org/10.1007/s00508-014-0678-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00508-014-0678-2

Keywords

  • Lung neoplasms
  • Spiral computed tomography
  • Biological tumor markers
  • Non-small cell lung cancer