Comparison of Cyfra 21–1, Tpa and Tps in Lung Cancer, Urinary Bladder Cancer and Benign Diseases

Abstract

Recently CYFRA 21-1, a new tumor marker measuring a fragment of cytokeratin 19, was introduced and proved to be suitable for therapy monitoring and follow-up of non-small cell lung carcinomas (NSCLC), in particular squamous cell carcinomas. Besides CYFRA 21-1 there are two other tumor markers, tissue polypeptide antigen (TPA) and tissue polypeptide-specific antigen (TPS), which also measure various cytokeratins in serum. In a retrospective study we investigated the clinical significance of these three cytokeratin markers in lung cancer and in carcinoma of the urinary bladder. For this purpose we investigated the sera of 50 healthy persons, 273 patients with various benign diseases, 218 patients with histologically proven lung cancer and 88 patients with carcinoma of the urinary bladder. In a first step the specificity was established for the different reference groups and the cutoff values were fixed at a specificity of 95%. In lung cancer the single and combined sensitivities were calculated versus benign lung diseases (n = 58) as reference group. With single determinations CYFRA 21-1 proved to have the highest sensitivity in lung cancer in general (61%), in non-small cell lung carcinomas (64%), in squamous cell carcinomas (79%), in adenocarcinomas (54%) and in large cell carcinomas (65%). In small cell lung carcinomas (SCLC) NSE was confirmed to be the marker of choice (55%). With combined determinations a clear increase in sensitivity could only be reached in large cell carcinomas (CYFRA 21-1 + TPA: 77%) and in small cell carcinomas (CYFRA 21-1 + NSE: 62%).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Carcinoembriyonic antigen, neurone specific enolase, cytokeratin 21-1 and ferritin levels in coal miners

“…The cut-off value of CYFRA 21-1 is 3.3 ng/mL. It is increased in cases of acute pneumonia, tuberculosis, interstitial lung diseases, cirrhosis and renal failure (20). There was no difference between pneumoconiosis and non-pneumoconiosis cases.…”

Cytokeratin-19 Fragment (CYFRA 21-1) in Bladder Cancer

“…Discussion report by Stieber et al [19], probably because we em ployed the higher cutoff level of 3.5 ng/ml. These studies showed that serum CYFRA 21-1 levels in bladder cancer patients increased significantly as tumor stage advanced, indicating that serum CYFRA 21-1 levels might reflect the tumor burden, as high-stage patients generally had a larger tumor burden than did low-stage patients.…”

“…In 23 bladder cancer patients, Rastei et al [5] reported that none of 9 patients in stages I and II and 6 of 14 patients in stages III and IV showed the serum CYFRA 21-1 levels over the cutoff lev el of 3.3 ng/ml with an overall sensitivity of 26%. Stieber et al [19] examined serum CYFRA 21-1 levels in 88 blad der cancer patients, and demonstrated that sensitivity was 4% in stage 0, 33% in stage I, 36% in stage II, 44% in stage III, and 73% in stage IV with an overall sensitivity of 38% when the cutoff level was set at 2.6 ng/ml. In the present study, at the cutoff level of 3.5 ng/ml, sensitivity was 6.9% at the low stage, 64.3% at the high stage without metasta sis, and 87.1 % at the high stage with metastasis with an overall sensitivity of 41.9%.…”

“…Thus there is a need to examine the factors that affect the serum CYFRA 21-1 levels in healthy volunteers and various benign diseases. The study in healthy volun teers showed that age, sex, and smoking habits do not influence the serum CYFRA 21-1 levels [5,6], The benign diseases in which the serum CYFRA 21-1 level is elevated are renal failure, liver cirrhosis, pulmonary tuberculosis, interstitial pneumonia, for example [4,5,8,18,19]. Among them, chronic renal failure was most frequently associated with elevated serum CYFRA 21-1 levels, which was also confirmed in the present study, suggesting that serum CYFRA 21-1 is cleared by the kidney [5,19].…”

“…Because of high sensitivity in chronic renal failure, patients with serum creatinine greater than 1.2 mg/dl were excluded from the remainder of the study. In addition, patients with lung or liver diseases which might influence the serum CYFRA 21-1 level [4,5,8,18,19] were also excluded. …”