Prognostic impact of Cyfra21-1 and other serum markers in completely resected non-small cell lung cancer

Lung Cancer. 2002 Jun;36(3):265-70. doi: 10.1016/s0169-5002(02)00009-0.


Purpose: The aim of this prospective study was to assess the prognostic impact of serum tumor markers (Cyfra21-1, carcinoembryonic antigen, neuron-specific enolase, squamous cell carcinoma-antigen and TPAcyk) in patients with non-small cell lung cancer (NSCLC) receiving complete resection.

Methods: Sixty-seven patients with histologically proven NSCLC and complete resection of stage I-IIIA disease were included. The serum levels of all markers were measured using commercially available immunoassays.

Results: With a median follow-up of 86 months for surviving patients, those with initial Cyfra21-1 serum levels higher than 3.57 ng/ml had a significantly worse prognosis (P=0.014). The remaining serum tumor markers showed no prognostic impact. In a Cox regression model, Cyfra21-1 proved to be an independent prognostic factor for both overall survival and disease-free interval. In addition, Cyfra21-1 sustained as an independent prognostic factor in completely resected stage I/II disease.

Conclusions: With a cut-off value of 3.57 ng/ml, Cyfra 21-1 was an independent prognostic factor for survival in NSCLC-patients with complete resection. Further evaluation is needed, particularly in stage I/II disease. When the prognostic impact is confirmed with larger patient numbers this may contribute to the identification of stratification variables for future treatment approaches of NSCLC.

MeSH terms

  • Antigens, Neoplasm / blood*
  • Biomarkers, Tumor / blood*
  • Carcinoembryonic Antigen / blood
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Keratin-19
  • Keratins
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Male
  • Phosphopyruvate Hydratase / blood
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Regression Analysis
  • Serpins*
  • Survival Analysis
  • Tissue Polypeptide Antigen / blood


  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Keratin-19
  • Serpins
  • Tissue Polypeptide Antigen
  • antigen CYFRA21.1
  • squamous cell carcinoma-related antigen
  • Keratins
  • Phosphopyruvate Hydratase