Comparison of Cyfra 21-1 and SCC Assays in Head and Neck Tumours

Abstract

Patients with head and neck tumours (HNT) have a high risk of early locoregional relapse that is difficult to diagnose. This study evaluated the usefulness of the serum Cyfra 21-1 assay compared to squamous cell carcinoma antigen (SCC) assay for monitoring such patients. Three hundred and twelve HNT patients, including 204 newly diagnosed patients, were followed up for a median of 446 days with serial serum assays for SCC and Cyfra 21-1. Untreated patients showed SCC and Cyfra 21-1 serum levels correlated with each other: concentration was correlated to clinical stage, tumour size (as T1 + T2 vs. T3 + T4) and nodal status. Cyfra 21-1, but not SCC, was related to the presence of metastases and the primary tumour site, with a univariate prognostic value for disease-free survival (p = 0.015). Cox’s regression analysis showed that only Cyfra 21-1 was associated with a risk of relapse (p = 0.027). The random coefficient growth curve model applied to serial SCC and Cyfra 21-1 measurements of 111 patients showed that only Cyfra 21-1 exhibited a significant difference between patients with and without relapses. We found Cyfra 21-1 to be more closely related to initial clinical data and disease evolution than SCC, and therefore propose the use of Cyfra 21-1 for monitoring head and neck cancers.

Analytical and clinical evaluation of CYFRA 21-1 by electrochemiluminescent immunoassay in head and neck squamous cell carcinoma: Author’s reply

“…The data including our study have shown that CYFRA 21-1 is a good marker for monitoring therapeutic effect, follow-up and prognostic value in patients with HNSCC. [2][3][4][5] Furthermore, many studies have shown that CYFRA 21-1 is useful for diagnosis of HNSCC. [5][6][7][8][9][10] We also believe that CYFRA 21-1 is an adjunct for the diagnosis of HNSCC.…”

“…Also, a decrease of the Cyfra 21-1-serum concentration after therapy in patients with squamous cell carcinomas of the head and neck has been seen earlier. 4 Cyfra 21-1 is a well accepted tumour marker in non-small-cell lung cancer. 6 The controversy about the usefulness of Cyfra 21-1 as serum tumour marker in head and neck squamous cell carcinomas is probably due to dif culties to nd the appropriate cut-off level.…”

“…Additionally, a wide range of Cyfra 21-1 serum levels were observed in patients at the time of primary tumour diagnosis. 2,4 Also, the Cyfra 21-1 serum levels vary widely in healthy persons. 8,9 Cytokeratins are not organ speci c, and they appear in all epithelial tumours, as well as in normal epithelium.…”

The Versatility of Cytokeratins asTumor Markers

“…In this issue of Tumor Biology three papers by Nap et al [2], Miédougé et al [3], and Banal et al [4] deal specifically with these cytokeratins, and their value as tumor markers. Their findings will be discussed in the context of our existing knowledge of cytokeratin structure and function.…”

“…In this issue two reports [3,4] are presented, indicating that cytokeratin 19 fragments (assayed by the Cyfra 21:1 assay) appear in extracellullar fluids during malignant diseases. These fragments are supposed to be generated by the proteolytic cleavage of cytokeratins in tumor cells, rendering the cytokeratins more soluble.…”