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Meta-Analysis
. 2015 Apr 22:5:9444.
doi: 10.1038/srep09444.

Prognostic value of serum cytokeratin 19 fragments (Cyfra 21-1) in patients with non-small cell lung cancer

Youtao Xu  1 , Lei Xu  2 , Mantang Qiu  3 , Jie Wang  4 , Qing Zhou  5 , Lin Xu  4 , Jian Wang  2 , Rong Yin  4
Affiliations
Meta-Analysis

Prognostic value of serum cytokeratin 19 fragments (Cyfra 21-1) in patients with non-small cell lung cancer

Youtao Xu et al. Sci Rep. .

Abstract

The role of serum CYFRA 21-1 level in patients with non-small cell lung cancer (NSCLC) remains to be defined. To re-evaluate the impact of serum CYFRA 21-1 in NSCLC survival, we performed this meta-analysis. Databases were searched to identify relevant studies reported after the publication of a meta-analysis in 2004. Totally, 31 studies with 6394 patients were included in this meta-analysis. The pooled Hazard ratios (HRs) indicated that high CYFRA 21-1 level was associated with poor prognosis on overall survival (OS) in patients with NSCLC (HR = 1.60; 95%CI = 1.36-1.89; P < 0.001). The pooled HRs were 2.18 (95%CI = 1.70, 2.80; P = 0.347) for patients at stage I-IIIA and 1.47 (95%CI = 1.02, 2.11; P < 0.001) for stage IIIB-IV. When stratified by surgical intervention, pooled HRs were 1.94 (95%CI = 1.42-2.67; P < 0.001) for studies with surgery and 1.24 (95%CI = 0.79-1.95; P < 0.001) for studies without surgery. Significant associations were also found in the patients treated with EGFR-TKIs (HR = 1.83; 95%CI = 1.31-2.58; P = 0.011) and platinum-based regimen (HR = 1.53; 95%CI = 1.18-1.99; P = 0.001). Meta-analysis of CYFRA 21-1 related to PFS was performed and pooled HR was 1.41 (95%CI = 1.19-1.69; P < 0.001). Our results indicate that high level of serum CYFRA 21-1 is a negative prognostic indicator of patients with NSCLC.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Flow chart of studies in the analysis.
Figure 2
Figure 2. The association between serum CYFRA 21-1 and overall survival of NSCLC stratified by TNM stage.
Figure 3
Figure 3. The association between serum CYFRA 21-1 and overall survival of NSCLC stratified by surgical intervention.
Figure 4
Figure 4. The association between serum CYFRA 21-1 and overall survival of NSCLC stratified by ethnicity.
Figure 5
Figure 5. The association between serum CYFRA 21-1 and overall survival of NSCLC stratified by chemotherapy regimen.
Figure 6
Figure 6. Funnel plot for OS, adjusted with trim and fill method Circles stand for included studies; diamonds stand for presumed missing studies.
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