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Date Published: 31/07/2025
Online Published: 10/07/2025
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DOI: https://doi.org/10.47972/vjcts.v51i.1384
Issue
Vol. 51
Section
Research Article
How to Cite
Vo, T. A., Nguyen, V. T., Kieu, M. S., Nguyen , T. H. N., Pham, D. P., & Nguyen, C. T. (2025). Revisiting the diagnostic and prosnotic performance of cyfra 21-1 and cea in non small cell lung cancer. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 51, 97 - 106. https://doi.org/10.47972/vjcts.v51i.1384

Revisiting the diagnostic and prosnotic performance of cyfra 21-1 and cea in non small cell lung cancer

Tuan Anh Vo1, , Van Thanh Nguyen1, Minh Son Kieu, Thoi Hai Nguyen Nguyen , Danh Phuong Pham1, Cong Tien Nguyen1
1 Dong Nai General Hospital

Main Article Content

Abstract

Introduction: Non-small cell lung cancer (NSCLC), a leading cause of cancer mortality, is often diagnosed late, necessitating reliable biomarkers. Carcinoembryonic Antigen (CEA) and Cytokeratin 19 Fragment (CYFRA 21-1) show promise for early detection and prognosis in NSCLC, but their performance requires further validation.


Methods: This retrospective study evaluated 135 patients at a tertiary hospital for lung cancer. Diagnostic performance of CEA and CYFRA 21-1 was assessed via Receiver Operating Characteristic (ROC) analysis, with subgroup analyses across histological subtypes. Survival was analyzed using Kaplan-Meier estimates and Cox proportional hazards models.


Results: Of 135 patients, 95 had NSCLC (70.4%). ROC analysis showed moderate diagnostic accuracy for CEA (AUC: 0.78, 95% CI: 0.70–0.85; cut-off: 5.5 ng/mL, sensitivity: 72%, specificity: 68%) and CYFRA 21-1 (AUC: 0.82, 95% CI: 0.75–0.88; cut-off: 3.8 ng/mL, sensitivity: 78%, specificity: 70%). Subgroup analysis revealed CYFRA 21-1’s superior accuracy in squamous cell carcinoma (AUC: 0.87, sensitivity: 82%, specificity: 75%) and adenocarcinoma (AUC: 0.84), while CEA performed better in poorly differentiated carcinoma (AUC: 0.77). Elevated CEA (>5.5 ng/mL) and CYFRA 21-1 (>3.8 ng/mL) predicted worse survival (HR: 1.5, 95% CI: 1.1–2.0; HR: 1.7, 95% CI: 1.2–2.3), reducing median survival to 12 and 10 months from 20 and 22 months, respectively.


Conclusion: CEA and CYFRA 21-1 enhance NSCLC diagnosis and prognosis, with histology-specific strengths, supporting their role in precision oncology.

Article Details

Keywords

NSCLC, CEA, CYFRA 21-1

References

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