CYFRA 21-1 in the early diagnosis of recurrent disease in non small cell lung carcinomas (NSCLC)

Due to its high specificity and sensitivity CYFRA 21-1 was found to be the leading marker in NSCLC. We focused our interest on the diagnostic value of CYFRA 21-1 in the detection of recurrent disease of 86 patients suffering from NSCLC following R0-resection (median follow up: 22.7 months). Preoperatively, CYFRA 21-1 was positive (cut off 3.3 ng/mL) in 38 of the 86 patients (45%). 48 hours after surgery all 38 patients had CYFRA 21-1-concentrations within the reference range corresponding to a R0-resection. During further follow up 22 of these patients developed local recurrence and/or distant metastases. All 22 patients showed elevated CYFRA 21-1-values at time of detection of relapse, in 8 patients the CYFRA 21-1-increase preceeded the detection of recurrence by 2 to 15 months. 16 patients remained disease free and had stable low CYFRA 21-1-values all the time. Out of the 48 preoperatively CYFRA 21-1-negative patients 15 developed recurrent disease. 7 of the 15 patients proved to express cytokeratin 19-fragments at this time. Conclusion: CYFRA 21-1 possesses a high specificity and sensitivity in the detection of recurrent disease of patients suffering from NSCLC and with elevated values at time of primary diagnosis. Thus CYFRA 21-1 could contribute to an economical follow up care. Even if there is not the possibility of curative therapy at time of relapse the early use of systemic therapy could be considered.