Diagnostic value of cytokeratin fragment 19 (CYFRA 21-1) in bronchoalveolar lavage fluid in lung cancer

Respir Med. 1998 May;92(5):766-71. doi: 10.1016/s0954-6111(98)90010-5.

Abstract

The aim of this study was to evaluate the diagnostic value of a new tumour marker, cytokeratin fragment 19 (CYFRA 21-1), in bronchoalveolar lavage fluid (BALF) for the diagnosis of lung cancer. The cross-sectional study included 36 patients with lung cancer, 19 with benign lung diseases and 13 control subjects. In the group with cancer, BAL was performed in the cancer-involved lung and in the opposite lung. Results in BALF were expressed both as absolute concentrations (ng ml-1) and referred to total protein (TP) (ng mg-1 TP), and results in plasma were expressed in ng ml-1. In BALF, there was no significant different between cancer and control groups. Using the 95th percentile of levels obtained in benign lung disease in BALF (specificity 95%) as the cut-off point, the sensitivity of CYFRA 21-1 was 13%. Positive and negative predictive values (PPV and NPV) at different pretest probabilities, and positive and negative gains were obtained applying a Bayesian analysis. Results showed low positive gains for PPV (maximal increase of 22%) and almost none for NPV (negative gains < 5%). In plasma, CYFRA 21-1 provided a sensitivity of 65%. The combination of BALF and plasma tumour marker levels showed a sensitivity of 69%. Therefore, measurement of CYFRA 21-1 in BALF has poor diagnostic value in lung cancer.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, Neoplasm / analysis*
  • Bayes Theorem
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / blood
  • Bronchoalveolar Lavage Fluid / chemistry*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Keratin-19
  • Keratins
  • Lung Diseases / blood
  • Lung Diseases / metabolism
  • Lung Neoplasms / blood
  • Lung Neoplasms / diagnosis*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Sensitivity and Specificity

Substances

  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Keratin-19
  • antigen CYFRA21.1
  • Keratins