Correlation of Cyfra 21-1 levels in saliva and serum with CK19 mRNA expression in oral squamous cell carcinoma

Abstract

Oral squamous cell carcinoma (OSCC) accounts for 90 % of malignant lesions of oral cavity. The study assessed the potential of Cyfra 21-1 as a tumor marker in OSCC. The study included 50 patients of OSCC to evaluate levels of Cyfra 21-1 in serum and saliva by electrochemiluminescent immunoassay (ECLIA) and CK19 messenger RNA (mRNA) expression in tissue by florescent quantitative real-time reverse transcriptase polymerase chain reaction (RT-PCR) along with healthy individuals as control. The salivary and serum Cyfra 21-1 levels in patients of OSCC were significantly higher compared to controls (p value < 0.01). There was a 2.75-fold increase in CK19 mRNA expression in OSCC cases compared to controls. A significant positive correlation was found between serum and salivary Cyfra 21-1, serum Cyfra 21-1, and CK19 mRNA expression and between salivary Cyfra 21-1 and CK19 mRNA expression. Among these, correlation between serum and salivary Cyfra 21-1 was highly significant. Salivary and serum Cyfra 21-1 showed significantly elevated levels in grade II OSCC compared to grade I histopathologically. Elevated levels of salivary Cyfra 21-1 were associated with recurrence in OSCC patients. Reverse operating curve constructed using 3 ng/ml as a cutoff for serum Cyfra 21-1 revealed the sensitivity and specificity to be 88 and 78.2 %, respectively. Using a cutoff value of 8.5 ng/ml for salivary Cyfra 21-1, the sensitivity was found to be 93.8 % and specificity 84.3 %. We advocate salivary Cyfra 21-1 as a better diagnostic marker over serum Cyfra 21-1 as well as a potential marker in the prognosis of OSCC.

Development of field cancerization in the clinically normal oral mucosa of shisha smokers

“…It is also worth mentioning that our results do not match most studies in the literature, in which a significant change in CYFRA 21‐1 was detectable . However, all these studies compared CYFRA 21‐1 levels in normal patients to their levels in patients with frank squamous cell carcinoma.…”

“…A recent study measured the diagnostic and prognostic significance of a lot of tumour markers in OSCC, and it was demonstrated that CYFRA 21‐1 showed a very high diagnostic and prognostic significance . A more recent study compared both salivary and serum levels of CYFRA 21‐1 in OSCC patients and normal patients and also demonstrated a significant increase in OSCC patients as well as a multifold increase in salivary levels compared to serum levels …”

Expression of CK19 is an independent predictor of negative outcome for patients with squamous cell carcinoma of the tongue

“…Other studies showed a positive correlation between salivary and serum CYFRA 21-1 and CK19 mRNA and protein expression [9, 14]. In this study CK19 expression did not have a significant correlation to tumor size or tumor stage.…”

“Search less, verify more”—Reviewing salivary biomarkers in oral cancer detection

“…CYFRA 21‐1 represents the soluble fragment of the acidic intermediate filament cytokeratin‐19 (CK‐19), released during apoptosis into the immediate milieu from epithelial malignancies. High salivary CYFRA 21‐1 expression has been observed in OSCC and positively correlated with CK19 mRNA expression . Using protein immunoassay techniques, SE and SP values obtained for salivary CYFRA 21‐1 have ranged from 83.6% to 93.8% and 84.3% to 95%, respectively .…”