Abstract
AB019. Prognostic impact of serum CYFRA 21-1 levels on postoperative outcomes of thymic epithelial tumors
Haruhiko Shiiya, Hideki Ujiie, Yuka Takakuwa, Shinya Otsuka, Hiroshi Yamasaki, Akihiro Sasaki, Kazuto Ohtaka, Aki Fujiwara-Kuroda, Masato Aragaki, Tatsuya Kato
Department of Thoracic Surgery, Hokkaido University Hospital, Sapporo, Japan
Correspondence to: Haruhiko Shiiya, MD, PhD. Department of Thoracic Surgery, Hokkaido University Hospital, Nishi 5, Kita 14, Kita-ku, Sapporo, Hokkaido 060-8648, Japan. Email: hshiiya@outlook.jp.
Background: Serum cytokeratin 19 fragment, measured using the CYFRA 21-1 immunoassay, is used as a tumor marker for squamous cell carcinomas in various malignant tumors. The usefulness of CYFRA21-1 as a diagnostic marker for thymic carcinoma has also been reported. Here, we evaluated the value of CYFRA 21-1 in predicting the postoperative prognosis of thymic epithelial tumors (TETs).
Methods: All patients who underwent surgery for TETs in our department between January 2000 and December 2019 were retrospectively reviewed. A total of 96 consecutive patients with TETs were initially collected. We excluded nine patients who underwent diagnostic surgery, three with ambiguous pathological diagnoses, and eight for whom CYFRA 21-1 information was not available. Ultimately, 76 patients were included in this study. The tumor-node-metastasis (TNM) staging records were reviewed and restaged according to the ninth edition of the TNM staging system. Patients were divided into two groups according to the threshold of the serum CYFRA 21-1 level based on the receiver-operating curve.
Results: Sixty-one patients with thymoma, 13 with thymic carcinoma, and two with thymic carcinoid were included in the analysis. Eligible patients were divided into two groups based on higher (n=27) and lower (n=49) CYFRA 21-1 levels according to a threshold value of 1.55 ng/mL. The proportion of thymic carcinoma was significantly higher in the higher CYFRA 21-1 group (higher CYFRA 21-1 group, 37% vs. lower CYFRA 21-1 group, 6.1%; P<0.01) and that of TNM stage >I was significantly higher in the higher CYFRA 21-1 group (higher CYFRA 21-1 group, 40.7% vs. lower CYFRA 21-1 group, 10.2%; P<0.01). Kaplan-Meier curves showed significantly poorer recurrence-free survival in the higher CYFRA 21-1 group (P<0.01).
Conclusions: Elevated serum CYFRA 21-1 levels may be associated with a diagnosis of thymic carcinoma, more advanced stage, and poorer prognosis after surgery.
Keywords: Thymoma; carcinoma; mediastinum; survival
Acknowledgments
Funding: None.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-24-ab019/coif). The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the institutional ethics board of Hokkaido University Hospital (No. 024-0098) and individual consent for this retrospective analysis was waived.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
doi: 10.21037/med-24-ab019
Cite this abstract as: Shiiya H, Ujiie H, Takakuwa Y, Otsuka S, Yamasaki H, Sasaki A, Ohtaka K, Fujiwara-Kuroda A, Aragaki M, Kato T. AB019. Prognostic impact of serum CYFRA 21-1 levels on postoperative outcomes of thymic epithelial tumors. Mediastinum 2024;8:AB019.
