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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2006 June;45(2):111-9
Low diagnostic efficacy of CEA, NSE, CYFRA 21-1 in primary lung cancer
Rizzo S., Bernasconi A.
SMP, Pavia, Pavia
Aim. To evaluate the diagnostic efficacy of CEA, NSE, CYFRA21-1 in first time investigated lung cancer patients and the possible correlation to sex, age, type, stage, delay in diagnosis.
Methods. Clinical histories, histology and CEA, NSE, CYFRA21-1 serum levels of 101 consecutive cases from a pulmonary department of northern Italy were collected from 2000 to 2003, cross-matched and statistically analysed. Sensitivity and specificity of at least 80% were assumed as good diagnostic efficacy index.
Results. Age and delay in diagnosis did not significantly differ compared for sex, age, type, stage, marker. Comparing early (I-II) against advanced (III-IV) stages, only NSE was in general significantly higher for stage IV vs others (p=0.026), all stages SCLCL vs NSCLC (p= 0.0129), stage IV SCLC vs NSCLC (p=0.018), stage IV vs other stages SCLC (p=0.017). Sensitivity and specificity were below 72%. Only CYFRA 21-1 stage IV vs others of SQC showed high but not significant sensitivity (92.3%) with low specificity (43.3%). The AUCs pairwise comparison of ROC curves showed a better performance of NSE against CEA in detecting SCLC from NSCLC (p=0.039). No difference was found comparing the AUCs of the three markers in discriminating stage IV from other stages.
Conclusion. CEA, NSE e CYFRA21-1 did not correlate to sex, age, delay in diagnosis, stage. Also sensitivity and specificity do not reach effective values to indicate the presence of a lung tumor. CEA, NSE e CYFRA21-1 play a limited role in the diagnosis of lung cancer and cannot substitute clinical, histological and image investigations.