Clinical Effectiveness of Tumor Markers (CEA, NSE, Cyfra 21-1) in Completely Resected Non-small Cell Lung Cancer

ABSTRACT

PURPOSE: The applicability of tumor markers still remains controversial in non-small cell lung cancer (NSCLC) due to lower sensitivity & specificity. And, tumor markers actually have not been used determining treatment plans in NSCLC patients yet. So, we evaluated correlation between levels of serum tumor marker (CEA, NSE and Cyfra 21-1) and prognosis in NSCLC patients underwent complete surgical resection. MATERIALS AND METHODS: We retrospectively studied 64 NSCLC patients underwent complete surgical resection in Yongdong severance hospital from April 2002 to October 2005. Preoperative and postoperative serum levels of tumor markers (CEA, NSE, Cyfra 21-1) were measured with commercialized kits and the correlation between the serum levels of tumor markers and prognosis was evaluated. Normal cutoff values of CEA, NSE and Cyfra 21-1 were 5.0 ng/ml, 12.5 ng/ml and 3.2 ng/ml. We estimated recurrence or distant metastasis with computed tomography, magnetic resonance imaging, whole body bone scan, positron emission tomography and biopsy. RESULTS: Preoperative and postoperative serum levels of tumor markers were not significantly correlated with lung cancer stages and histologies. The elevated levels of postoperative CEA (p=0.0142) and Cyfra 21-1 (p=0.0105) were correlated with shortened survival time. And, the shortened disease free interval was significantly associated with the elevated level of postoperative Cyfra 21-1 (p=0.0018). The elevated level of preoperative Cyfra 21-1 (p=0.0566) had a tendency to relate the shortened survival time, but it didn't reach statistical importance. CONCLUSION: Considering previous results, especially Cyfra 21-1 may be useful prognostic factor in predicting survival times, and recurrence or metastasis. But, further study and longer follow-up period were needed to make conclusion regarding usefulness of other tumor markers