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Shiiya H, Ujiie H, Hida Y, Kato T, Kaga K, Wakasa S, Kikuchi E, Shinagawa N, Okada K, Ito YM, Matsuno Y. Elevated serum CYFRA 21-1 level as a diagnostic marker for thymic carcinoma. Thorac Cancer 2021; 12:2933-2942. [PMID: 34581013 PMCID: PMC8563155 DOI: 10.1111/1759-7714.14158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 02/06/2023] Open
Abstract
Background No useful tumor markers have been identified for the diagnosis of thymic carcinomas. 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. Here, we evaluated the value of CYFRA 21‐1 in diagnosing thymic carcinoma. Methods We retrospectively reviewed 94 patients with pathological diagnoses of thymic carcinoma or thymoma (32 and 62 patients, respectively) who were referred to our departments between January 2000 and March 2019. Primary outcomes included tumor marker levels and their diagnostic accuracy. Results Patients with thymic carcinoma were significantly more likely to be male (thymic carcinoma, 68.8%; thymoma, 40.3%; p = 0.02), have an advanced TNM stage (p < 0.01), and a significantly higher CYFRA 21‐1 level than those with thymoma (thymic carcinoma: median = 4.2 ng/ml; interquartile range [IQR] = 2.1–6.1 ng/ml vs. thymoma: median = 1.2 ng/ml; IQR = 0.9–1.7 ng/ml; p < 0.01). Receiver operating characteristic curves demonstrated that the area under the curve for CYFRA 21‐1 to distinguish thymic carcinoma from thymoma was 0.86 (95% confidence interval [CI]: 0.74–0.93; cutoff = 2.7 ng/ml; sensitivity = 68.8%; specificity = 95.2%). Multivariable analysis demonstrated that CYFRA 21‐1 (odds ratio = 25.6; 95% CI: 4.6–141.6; p < 0.01) was an independent predictor for thymic carcinoma after adjusting for TNM stage. Conclusions Serum CYFRA 21‐1 level may help in diagnosing thymic carcinoma.
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Affiliation(s)
- Haruhiko Shiiya
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hideki Ujiie
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasuhiro Hida
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tatsuya Kato
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kichizo Kaga
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoru Wakasa
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Eiki Kikuchi
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Naofumi Shinagawa
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kazufumi Okada
- Biostatistics Division, Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | - Yoichi M Ito
- Biostatistics Division, Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | - Yoshihiro Matsuno
- Department of Surgical Pathology, Hokkaido University Hospital, Hokkaido University, Sapporo, Japan
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Haen SP, Stroebel P, Marx A, Suesskind D, Fend F, Reichmann U, Kopp HG, Kanz L, Mayer F. Choroidal metastases from thymic carcinoma during pregnancy: Case Report. BMC Cancer 2015; 15:972. [PMID: 26675671 PMCID: PMC4682268 DOI: 10.1186/s12885-015-1968-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 12/01/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Rare sites of metastases, atypical symptoms and paraneoplastic syndromes are often neglected or misinterpreted, especially when they represent early symptoms of an underlying malignant disease. Hence, an interdisciplinary approach to these patients is essential to avoid tumor progression and metastatic spread in order to provide curative treatment options to the patients. We here report the case of a young woman presenting with visual loss which led to diagnosis of a thymic carcinoma. CASE PRESENTATION A 28-year old white woman presented with subacute loss of vision in the last trimester of her first pregnancy which was first interpreted as an exacerbation of a pre-existing dermatomyositis and treated with steroids. After failure of steroid therapy choroidal metastases from an undifferentiated thymic carcinoma were diagnosed. This also shed a new light on the dermatomyositis the patient had been suffering from for seven years possibly representing a paraneoplastic syndrome from the tumor. Despite aggressive chemotherapy, the patient died from progressive disease eight years after first onset of dermatomyositis and 14 months after initial diagnosis of the thymic carcinoma. CONCLUSIONS Choroidal metastases from a thymic carcinoma have never been reported before but should be included into the differential diagnosis of choroidal masses.
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Affiliation(s)
- Sebastian P Haen
- Medizinische Universitaetsklinik Tuebingen, Innere Medizin II fuer Onkologie, Haematologie, Immunologie, Rheumatologie und Pulmologie, Otfried Mueller Str. 10, D-72076, Tuebingen, Germany. .,Interfakultaeres Institut fuer Zellbiologie, Abteilung Immunologie, Auf der Morgenstelle 15, D-72076, Tuebingen, Germany.
| | - Philipp Stroebel
- Pathologisches Institut, Universitaetsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany. .,Institut fuer Pathologie, Universitaetsmedizin Goettingen, Robert-Koch-Str. 40, D-37075, Goettingen, Germany.
| | - Alexander Marx
- Pathologisches Institut, Universitaetsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.
| | - Daniela Suesskind
- Departement fuer Augenheilkunde, Universitaetsklinikum Tuebingen, Schleichstr. 12, D-72076, Tuebingen, Germany.
| | - Falko Fend
- Institut fuer Pathologie, Abteilung fuer Allgemeine Pathologie und Pathologische Anatomie, Universitaetsklinikum Tuebingen, Liebermeisterstr. 8, D-72076, Tuebingen, Germany.
| | - Ursula Reichmann
- Radioonkologische Klinik, Universitaetsklinikum Tuebingen, Hoppe-Seyler-Str. 3, D-72076, Tuebingen, Germany.
| | - Hans-Georg Kopp
- Medizinische Universitaetsklinik Tuebingen, Innere Medizin II fuer Onkologie, Haematologie, Immunologie, Rheumatologie und Pulmologie, Otfried Mueller Str. 10, D-72076, Tuebingen, Germany.
| | - Lothar Kanz
- Medizinische Universitaetsklinik Tuebingen, Innere Medizin II fuer Onkologie, Haematologie, Immunologie, Rheumatologie und Pulmologie, Otfried Mueller Str. 10, D-72076, Tuebingen, Germany.
| | - Frank Mayer
- Medizinische Universitaetsklinik Tuebingen, Innere Medizin II fuer Onkologie, Haematologie, Immunologie, Rheumatologie und Pulmologie, Otfried Mueller Str. 10, D-72076, Tuebingen, Germany.
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