J Korean Neurol Assoc.  2019 May;37(2):161-165. 10.17340/jkna.2019.2.7.

Cerebrospinal Fluid CYFRA 21-1 as a Diagnostic Indicator for Leptomeningeal Metastasis in Cancer Patients

Affiliations
  • 1Department of Neurology, National Cancer Center, Goyang, Korea. hojinkim@ncc.re.kr
  • 2Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.
  • 3Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea.
  • 4Department of Laboratory Medicine, National Cancer Center, Goyang, Korea.
  • 5Department of Laboratory Medicine, National Medical Center, Seoul, Korea.
  • 6Peripheral Neuropathy Research Center and Department of Neurology, Dong-A University College of Medicine, Busan, Korea.
  • 7Neuro-Oncoloy Clinic, National Cancer Center, Goyang, Korea.

Abstract

BACKGROUND
The early and accurate diagnosis of leptomeningeal metastasis (LM) has become important because of introduction of new therapeutic strategies for LM and increasing incidence of LM along with longer survival of cancer patients. We aimed to evaluate the role of cerebrospinal fluid (CSF) CYFRA 21-1 as a diagnostic indicator for LM in patients with cancer.
METHODS
CSF CYFRA 21-1 level was analyzed using electro-chemiluminescent immunoassay. The difference in concentration of CSF CYFRA 21-1 between 91 patients with LM and 339 control groups (patients with other neurological disease or healthy controls) was investigated. The cut-off value of CSF CYFRA 21-1 as a diagnostic indicator for LM and its diagnostic performance were evaluated.
RESULTS
The CSF CYFRA 21-1 was significantly higher in LM patients than control groups (p<0.001). A cut-off value of diagnosis for LM in patients with cancer was 1.59 ng/mL. The sensitivity, specificity, accuracy, and positive and negative predictive values of CSF CYFRA 21-1 were 80.2%, 96.2%, 92.8%, 84.9%, 94.8% for diagnosis of LM.
CONCLUSIONS
These results suggested that CSF CYFRA 21-1 can be an additional diagnostic indicator for cancer patients with LM.

Keyword

Neoplasm metastasis; Diagnosis; Cerebrospinal fluid; CYFRA 21-1

MeSH Terms

Cerebrospinal Fluid*
Diagnosis
Humans
Immunoassay
Incidence
Neoplasm Metastasis*
Sensitivity and Specificity
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