CYFRA 21-1 in patients with suspected cancer: evaluation of an optimal cutoff to assess the diagnostic efficacy and prognostic value

Synergistic Assembly of 1DZnO and Anti-CYFRA 21-1: A Physicochemical Approach to Optical Biosensing

Objective: We conducted a comprehensive physicochemical analysis of one-dimensional ZnO nanowires (1DZnO), incorporating anti-CYFRA 21-1 immobilization to promote fast optical biomarker detection up to 10 ng ml-1. Impact Statement: This study highlights the effectiveness of proof-of-concept 1DZnO nanoplatforms for rapid cancer biomarker detection by examining the nanoscale integration of 1DZnO with these bioreceptors to deliver reliable photoluminescent output signals. Introduction: The urgent need for swift and accurate prognoses in healthcare settings drives the rise of sensitive biosensing nanoplatforms for cancer detection, which has benefited from biomarker identification. CYFRA 21-1 is a reliable target for the early prediction of cancer formation that can be perceptible in blood, saliva, and serum. However, 1DZnO nanostructures have been barely applied for CYFRA 21-1 detection. Methods: We assessed the nanoscale interaction between 1DZnO and anti-CYFRA 21-1 antibodies to develop rapid CYFRA 21-1 detection in two distinct matrices: PhosphateBuffered Saline (PBS) buffer and artificial saliva. The chemical modifications were tracked utilizing Fourier transform infrared spectroscopy, while transmission electron microscopy and energy dispersive spectroscopy confirmed antigen-antibody interplay over nanostructures. Results: Our results show high antibody immobilization efficiencies, affirming the effectiveness of 1DZnO nanoplatforms for rapid CYFRA 21-1 testing within a 5-min detection window in both PBS and artificial saliva. Photoluminescence measurements also revealed distinct optical responses across biomarker concentrations ranging from 10 to 1,000 ng ml-1. Conclusion: Discernible PL signal responses obtained after 5 min affirm the potential of 1DZnO nanoplatforms for further advancement in optical biomarker detection for application in early cancer prognosis.

Imbalance of Circulating Follicular Regulatory and Follicular Helper T Cell Subpopulations Is Associated with Disease Progression and Serum CYFRA 21-1 Levels in Patients with Non-small Cell Lung Cancer

OBJECTIVE

This study aimed to investigate the changes of follicular helper T (TFH) and follicular regulatory T (TFR) cell subpopulations in patients with non-small cell lung cancer (NSCLC) and their significance.

METHODS

Peripheral blood was collected from 58 NSCLC patients at different stages and 38 healthy controls. Flow cytometry was used to detect TFH cell subpopulation based on programmed death 1 (PD-1) and inducible co-stimulator (ICOS), and TFR cell subpopulation based on cluster determinant 45RA (CD45RA) and forkhead box protein P3 (FoxP3). The levels of interleukin-10 (IL-10), interleukin-17a (IL-17a), interleukin-21 (IL-21), and transforming growth factor-β (TGF-β) in the plasma were measured, and changes in circulating B cell subsets and plasma IgG levels were also analyzed. The correlation between serum cytokeratin fragment antigen 21-1 (CYFRA 21-1) levels and TFH, TFR, or B cell subpopulations was further explored.

RESULTS

The TFR/TFH ratio increased significantly in NSCLC patients. The CD45RA+FoxP3int TFR subsets were increased, with their proportions increasing in stages II to III and decreasing in stage IV. PD-1+ICOS+TFH cells showed a downward trend with increasing stages. Plasma IL-21 and TGF-β concentrations were increased in NSCLC patients compared with healthy controls. Plasmablasts, plasma IgG levels, and CD45RA+FoxP3int TFR cells showed similar trends. TFH numbers and plasmablasts were positively correlated with CYFRA 21-1 in stages I-III and negatively correlated with CYFRA 21-1 in stage IV.

CONCLUSION

Circulating TFH and TFR cell subpopulations and plasmablasts dynamically change in different stages of NSCLC, which is associated with serum CYFRA 21-1 levels and reflects disease progression.

Establishment of Reference Intervals of Cytokeratin 19 Fragment Antigen 21-1 in Korean Adults

Cytokeratin 19 fragment antigen 21-1 (CYFRA 21-1) is useful for predicting and monitoring non-small cell lung cancer prognosis. We established reference intervals (RIs) of CYFRA 21-1 in Korean adults, including those older than 60 years. Data of 4,098 apparently healthy subjects (age range, 20-87 years) were analyzed after excluding those with a history of malignancy, high tumor marker concentrations (except CYFRA 21-1), and/or abnormal findings on a chest computed tomography scan through medical chart review. After removing two outliers, RIs of CYFRA 21-1 were determined using data of 4,096 subjects based on the non-parametric method (2.5th and 97.5th percentiles) according to CLSI guidelines EP28-A3c. The subjects were divided into two and four groups according to sex and age (20-40, 41-50, 51-60, and >60 years), respectively, and the median CYFRA 21-1 concentration was compared between the groups. The RI of CYFRA 21-1 was 0.66-3.84 ng/mL, applicable to both men and women. Regardless of sex, the CYFRA 21-1 concentration increased with age, suggesting that age-dependent RIs of CYFRA 21-1 should be applied. Rather than using a single RI provided by the manufacturer, the RI of CYFRA 21-1 should be continually verified and established in each clinical laboratory.