The prognostic value of the tumour marker Cyfra 21-1 in carcinoma of head and neck and its role in early detection of recurrent disease

• Published in: British journal of cancer Vol. 83; no. 12; pp. 1696 - 1701
• Main Authors: DOWECK, I, BARAK, M, URI, N, GREENBERG, E
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.12.2000
• Subjects: Aged; Antigens, Neoplasm - analysis; Biological and medical sciences; Biomarkers, Tumor - analysis; Cancer research; Cytokeratin; Enzyme-Linked Immunosorbent Assay; Female; Follow-Up Studies; Head & neck cancer; Head and Neck Neoplasms - metabolism; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Humans; Keratin-19; Keratins; Male; Medical research; Medical sciences; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Predictive Value of Tests; Prognosis; Regular; Survival Analysis; Survival Rate; Tumors; Adenocarcinoma; Human; Carcinoma; Prognosis; Peptide fragment; Head and neck; ENT disease; Tumoral marker; Cytokeratin 19; Malignant tumor; Diagnosis; Recurrent
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1054/bjoc.2000.1502

This study examines a new tumour marker, Cyfra 21-1, as a prognostic marker in predicting the survival of H&N cancer patients, and its correlation with clinical outcome during prolonged follow up of these patients. The study included 67 patients with primary detection of carcinoma of H&N. The survival of these patients was evaluated in correlation with the disease stage and Cyfra 21-1 levels at initial diagnosis. 38 patients were followed clinically and with serial assays for at least 12 months, or until recurrence was diagnosed. Cyfra 21-1 levels were determined periodically, using an Elisa kit. Patients with Cyfra 21-1 < 1.5 ng ml(-1)had a higher survival rate compared to patients with Cyfra 21-1 > or = 1.5 ng ml(-1)(63% vs. 20%, respectively). The risk ratio of Ln(Cyfra 21-1) is 1.62 (P = 0.028). In a Cox regression model that included the disease stage and Ln(Cyfra 21-1), Ln(Cyfra 21-1) was preferred as the main parameter for predicting patients survival. In 83% of the 12 patients with recurrent or residual disease, Cyfra 21-1 was elevated before or during clinical detection of the recurrence. Cyfra 21-1 was found to be a prognostic marker for carcinoma of H&N, unrelated to the stage of the disease. Elevated levels of Cyfra 21-1 without clinical evidence of disease can be attributed to the marker's mean lead-time as compared to the clinical appearance of the disease.