Diagnostic values of serum tumor markers CA72-4, SCCAg, CYFRA21-1, NSE, AFU, CA125, CA19-9, CEA and FER in nasopharyngeal carcinoma

Yong-Fei Tang, Wen Li, Jing-Ping Yuan, Ya-Bing Huang, Hong-Lin Yan, Lin Liu, Xiang-Pan Li, Ming Wang


Background: The purpose of this study was to explore the clinical diagnostic values of serum tumor markers (TMs) including squamous cell carcinoma antigen (SCCAg), cytokeratin 19 fragment (CYFRA21-1), neuron specific enolase (NSE), alpha-L-fucosidase (AFU), carbohydrate antigen (CA)72-4, CA125, CA19-9, carcinoembryonic antigen (CEA) and ferritin (FER) in nasopharyngeal carcinoma (NPC).
Methods: Two hundred and two newly diagnosed NPC patients and seventy-two benign nasopharyngeal diseases (BND) patients were retrospective reviewed. The levels of serum CA72-4, CYFRA21-1, SCCAg, NSE, AFU, FER, CEA, CA125 and CA19-9 were measured by chemiluminescent assay. AFU serum levels were detected by using continuous monitoring method. The non-parametric Mann-Whitney U test was used to compare median levels of TMs between the benign group and NPC group. Logistic stepwise regression analysis and the receiver operating characteristic (ROC) curve were firstly used in screening TMs in NPC, and then the decision tree was applied to evaluate the diagnostic value of TMs in NPC.
Results: The levels of serum CA72-4, CYFRA21-1, NSE and FER in patients with NPC were significantly higher than those with the BND (P<0.05). For CEA, SCCAg, AFU, CA19-9 and CA125, there is no significant difference in the serum of NPC and benign control (P>0.05). AFU and CA72-4 were eliminated by Logistic regression stepwise analysis. Logistic regression showed that CA72-4, CYFRA21-1, NSE, CA125, CA19-9, CEA and FER OR (95% CI) of risk of NPC events were 1.09 (0.96–1.24, P=0.176), 2.42 (1.66–3.68, P<0.001), 1.30 (1.16–1.46, P<0.001), 0.96 (0.92–1, P=0.043), 1.042 (0.994–1.0994, P=0.099), 0.67 (0.47–0.94, P=0.022) and 1.003 (1.0007–1.005, P=0.014). NSE and CYFRA21-1 were selected for the conditional inference tree (CTree). When NSE >15.90, the positive predictive value was 93.9%. In the lower NSE group, when the CYFRA21-1 was greater than 3.3, the positive predictive value was 92.3%.
Conclusions: The combination of CYFRA21-1 and NSE will be beneficial for distinguishing NPC from BND.