The Role of Change Rates of CYFRA21-1 and CEA in Predicting Chemotherapy Efficacy for Non-Small-Cell Lung Cancer.

Tongwei Zhao,Ming Chen,Guangyun Mao,Tao Huang

doi:10.1155/2021/1951364

Abstract

Background Cytokeratin 19 fragment 21-1 (CYFRA21-1) and carcinoembryonic antigen (CEA) are effective prognostic biomarkers for lung cancer. This study investigated the predictive effects of change rates of CYFRA21-1 and CEA before and after the first cycles of chemotherapy on advanced IIIb/IIIc or IV stage non-small-cell lung cancer (NSCLC) patients. Methods Data of 103 NSCLC patients who received chemotherapy in Zhejiang Provincial People's Hospital from February 2018 to November 2020 were retrospectively analyzed. All patients received platinum doublet chemotherapy for at least 2 cycles. CYFRA21-1 and CEA levels of patients were detected before and after the first chemotherapy cycle, respectively. After the second cycle, the efficacy was evaluated, and patients were divided into the disease control (DC) and progressive disease (PD) groups. The generalized linear model (GLM) and linear trend test assessed the relationship between change rates of CYFRA21-1 and CEA levels and chemotherapeutic efficacy before and after chemotherapy. Moreover, the receiver operating characteristic (ROC) curve determined the predictive value of change rates of CYFRA21-1 and CEA on chemotherapeutic efficacy. Results After the second chemotherapeutic cycle, there were 92 patients in the DC group and 11 in the PD group. GLM and linear trend test both indicated that change rates of CYFRA21-1 and CEA were inversely correlated with chemotherapeutic efficacy for NSCLC. Change rates of CYFRA21-1 and CEA were used to predict area under the ROC curve of chemotherapeutic efficacy (0.87, 0.71-1.00), which is better than single index prediction of CYFRA21-1 (0.71, 0.49-0.94) or CEA change rate (0.85, 0.69-1.00) (p < 0.001). Conclusion Before and after chemotherapy of the first cycle for advanced NSCLC patients, combining serum CYFRA21-1 and CEA levels could increase sensitivity and specificity to predict the chemotherapeutic efficacy and guide the following therapy of advanced NSCLC patients.

Highlights

Lung cancer (LC) is a major cause of global deaths [1]
There are intensive studies on serum biomarkers in predicting cancer treatment efficacy, while few studies look into corresponding markers that could predict the early efficacy of cancer treatment
This study revealed that change rates of CYFRA21-1 and carcinoembryonic antigen (CEA) before and after the first chemotherapeutic cycle were negatively correlated with chemotherapeutic efficacy, and they held high diagnostic value in predicting the chemotherapy efficacy

Summary

Introduction

Lung cancer (LC) is a major cause of global deaths [1]. Nonsmall-cell lung cancer (NSCLC) accounts for 85% of all diagnosed LC cases, and 70% of patients are already in the advanced stage (stage IIIB/IV) at diagnosis [2]. This study investigated the predictive effects of change rates of CYFRA21-1 and CEA before and after the first cycles of chemotherapy on advanced IIIb/IIIc or IV stage non-small-cell lung cancer (NSCLC) patients. The generalized linear model (GLM) and linear trend test assessed the relationship between change rates of CYFRA211 and CEA levels and chemotherapeutic efficacy before and after chemotherapy. The receiver operating characteristic (ROC) curve determined the predictive value of change rates of CYFRA21-1 and CEA on chemotherapeutic efficacy. GLM and linear trend test both indicated that change rates of CYFRA21-1 and CEA were inversely correlated with chemotherapeutic efficacy for NSCLC. Before and after chemotherapy of the first cycle for advanced NSCLC patients, combining serum CYFRA21-1 and CEA levels could increase sensitivity and specificity to predict the chemotherapeutic efficacy and guide the following therapy of advanced NSCLC patients

Methods

Results

Conclusion