A Comparison of CYFRA 21-1, NSE, and CEA for the Serodiagnosis of Lung Cancer

Alexandra Knopp, University of Southern Mississippi
James T. Johnson, University of Southern Mississippi
Margot Hall, University of Southern Mississippi


There were 224,210 new cases of lunch cancer in the US during 2014, and 159,260 died from lung cancer during that year [1]. Since early diagnosis and treatment leads to a better prognosis, the medical community is actively looking for new, non-invasive diagnostic tests for the disease. This includes the search for new and effective tumor markers. Tumor markers are used in combination with other tests to diagnose cancer. After the diagnosis, they are used to follow a patient's case. The three tumor markers studied were neuron specific enolase (NSE), carcinoembryonic antigen (CEA), and CYFRA 21-1. In this study, the normal reference intervals were developed using sera from healthy adult donors. The analytical properties of the tumor marker assays were tested for and found to be satisfactory. The study was designed to compare the diagnostic and predictive values for the three tumor markers. Preliminary results on 638 patients (76 lung cancer patients, 562 healthy/non cancer patients) included: (1) diagnostic % sensitivity (CEA: 22.37%, NSE: 0.00%, CYFRA 21-1: 18.92%), (2) diagnostic % specificity (CEA: 80.43%, NSE: 99.39%, CYFRA 21-1: 93.16%), (3) %PV+ (CEA: 13.39%, NSE: 4.17%, CYFRA 21-1: 28.00%), (4) %PV- (CEA: 88.45%, NSE: 87.12%, CYFRA 21-1: 89.09%), (5) % efficiency (CEA: 73.51, NSE: 86.65%, CYFRA 21-1: 84.00%). It was hypothesized that CYFRA 21-1 would be superior to CEA and NSE for the sero-diagnosis of lung cancer in a cohort of patients, and the hypothesis was rejected.