Korean J Fam Pract. 2018; 8(1): 73-79  https://doi.org/10.21215/kjfp.2018.8.1.73
Lack of Clinical Utility for CYFRA 21-1 in Medical Screening
Jungman Kim, Hyeyoung Jung, Dowi Kim, Soohyung Lee*, Mooyoung Kim, Kihyun Park
Department of Family Medicine, Seoul Medical Center, Seoul, Korea
Soohyung Lee
Tel: +82-2-2276-7944, Fax: +82-2-2276-7377
E-mail: jasinita@hanmail.net
ORCID: http://orcid.org/0000-0002-0064-0388
Received: March 13, 2017; Revised: July 6, 2017; Accepted: July 26, 2017; Published online: February 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: We analyzed the clinical utility of cytokeratin 19 fragments (CYFRA 21-1) as a biomarker for lung cancer. We evaluated the relationship between CYFRA 21-1 and low-dose chest computed tomography (CT), as well as the various factors affecting CYFRA 21-1 concentration.
Methods: A total of 1,007 Metropolitan officers who underwent medical checkup at the Seoul Medical Center in 2014 were analyzed in this study. To evaluate CYFRA 21-1 as a biomarker, we analyzed the factors affecting its concentration, the correlation between CYFRA 21-1 and low-dose lung CT findings, and the factors affecting CYFRA 21-1 values.
Results: The mean CYFRA 21-1 concentration was 1.74 ng/mL. The sensitivity, specificity, and positive predictive value of CYFRA 21-1 for lung cancer was 0%, 94.4%, and 0%, respectively. Age, sex, smoking history, hypertension, diabetes and hepatitis B infection all affected the prognostic value of CYFRA 21-1. Low-dose chest CT scan was performed in 208/1,007 patients and no correlation was found between CT findings and CYFRA 21-1 concentration. Logistic regression analysis showed that diabetes, other cancers and smoking were independent factors affecting CYFRA 21-1 concentration.
Conclusion: CYFRA 21-1 is not an efficient biomarker for lung cancer. The concentration of CYFRA 21-1 is affected by age, sex, smoking status, blood pressure, diabetes and hepatitis B.
Keywords: Tumor Marker; CYFRA 21-1; Medical Screening; Lung Cancer
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