Analysis of tumor markers in the cytological fluid obtained from computed tomography-guided needle aspiration biopsy for the diagnosis of non-small cell lung cancer

Yoo Jin Hong, Jin Hur, Hye Jeong Lee, Ji Eun Nam, Young Jin Kim, Hua Sun Kim, Hee Yeong Kim, Se Kyu Kim, Joon Chang, Joo Hang Kim, Kyung Young Chung, Byoung Wook Choi, Kyu Ok Choe

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11 Citations (Scopus)

Abstract

Purpose: The aim of this study was to prospectively assess whether analysis of the tumor markers cytokeratin 19 fragments (CYFRA 21-1), carcinoembryonic antigen (CEA), and squamous cell carcinoma (SCC) antigen in cytological fluid can improve the performance of computed tomography (CT)-guided needle aspiration biopsy (NAB) in the diagnosis of non-small cell lung cancer (NSCLC). Methods: A total of 100 patients (men:women = 41:59, mean age: 63 years) with suspected malignant pulmonary lesions were prospectively enrolled for CT-guided NAB procedures. Levels of CYFRA 21-1, CEA, and SCC in the cytological fluid were measured by immunoradiometric assays. The cutoff value for tumor markers was selected on the basis of best accuracy through receiver operating characteristic curves. The sensitivity and areas under the curve (AUC) of NAB alone were compared with those of NAB combined with cytological tumor markers (CYFRA 21-1, CEA, and SCC). Results: Among 100 patients, 71 (71%) had NSCLC and 29 (29%) had benign lesions. The sensitivity, specificity, and accuracy for diagnosing NSCLC were 85.7%, 100%, and 89%, respectively, for NAB alone. The sensitivity increased significantly for NAB combined with a tumor marker compared with NAB alone (100% for CYFRA 21-1, 92.9% for CEA, and 94.2% for SCC; p = 0.001, p = 0.025, and p = 0.014, respectively). The AUC of NAB with CYFRA 21-1 was significantly larger than the AUC of NAB alone (p = 0.001). Conclusion: Evaluation of tumor markers CYFRA 21-1, CEA, and SCC in the cytological fluid can improve the diagnostic performance of CT-guided NAB for NSCLC. Of these markers, CYFRA 21-1 is the most useful cytological tumor marker.

Original languageEnglish
Pages (from-to)1330-1335
Number of pages6
JournalJournal of Thoracic Oncology
Volume6
Issue number8
DOIs
Publication statusPublished - 2011 Aug

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine

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