Author of

• 17629

  +

  P2.03b - Poster Session with Presenters Present (ID 465)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17667

    +

    P2.03b-038 - The Diagnostic and Prognostic Value of CSF Cyfra 21-1 in Patients with Leptomeningeal Metastasis of Non-Small Cell Lung Cancer (ID 6345)

    14:30 - 14:30  |  Author(s): H.J. Kim
    • Abstract

    Background:
    Cyfra 21-1, belonging to the intermediate filament protein, is responsible for the mechanical integrity of the cell and celluar processes such as cell division. Cyfra 21-1 in cerebrospinal fluid (CSF) has been proposed as a diagnostic and prognostic marker in patients with leptomeningeal carcinomatosis. We aimed to evaluate the diagnostic and prognostic value of CSF cyfra 21-1 in patients with leptomeningeal metastasis (LM) of non-small cell lung cancer (NSCLC).
    
    Methods:
    CSF cyfra 21-1 was measured by chemiluminescence immunoassay in cerebrospinal fluid (CSF) samples of LM patients with NSCLC (n = 36) and other neurological diseases (n=209, OND, multiple sclerosis, neuromyelitis optica spectrum disorder, Guillain-Barre syndrome, headache) from National Cancer Center in Korea. Diagnosis of LM was made via positive CSF cytology and/or MRI scans showing LM. Upper normal limit (UNL) was calculated by two times of mean value plus two standard deviation (3.46 ng/ml). Overall survival was defined as the time elapsed from the start of intra-thecal chemotherapy to death and survival curves were analyzed according to the Kaplan-Meier method.
    
    Results:
    CSF cyfra 21-1 (22 ± 83 vs. 1.4 ± 0.1 ng/ml, p<0.001) was significantly higher in LM patients with NSCLC than patients with OND. Diagnostic sensitivity, specificity, positive and negative predictive values for LM with NSCLC were estimated 41%, 100%, 100% 91% in CSF cyfra 21-1 and 67%, 100%, 100%, 95% in CSF cytology, respectively. Two of 12 cytology-negative patients showed high CSF cyfra 21-1 (over 3.46 ng/ml). CSF cyfra 21-1 was significantly higher in cytology-positive LM patients than cytology-negative LM patients (31.4 ± 101 vs. 3.1 ± 3.5 ng/ml, p=0.004). The median overall survival was longer in LM patients with low CSF cyfra 21-1 than those with high CSF cyfra 21-1, although it did not reach statistical significance (median 5 vs. 2 months, p=0.163).
    
    Conclusion:
    These findings suggested that CSF cyfra 21-1 could be used as an additional diagnostic and prognostic biomarker for LM of NSCLC.