Cyfra 21-1: A New Potential Tumor Marker for Squamous Cell Carcinoma of Head and Neck

Doweck, Ilana; Barak, Mira; Greenberg, Elhanan; Uri, Nechama; Kellner, Judith; Lurie, Miriam; Gruener, Nachman

doi:10.1001/archotol.1995.01890020039009

Cited by 68 publications

(58 citation statements)

References 13 publications

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“…This finding was unexpected; however, the correlation between the serum Cyfra 21-1 level and the survival rate was expected. A previous study found that Cyfra 21-1 levels were indeed correlated to the extent of the disease, as expressed by the T and N classifications in squamous cell carcinoma of head and neck (Doweck et al, 1995). However, in our study, the prognostic value of Cyfra 21-1 is independent of the stage of the disease.…”

Section: Discussioncontrasting

confidence: 70%

“…77% of patients with no evidence of disease also had no elevation in the marker level. Previous studies show that Cyfra 21-1 levels drop to below cut-off levels 24 hours after successful operation (Ebert et al, 1994;Van der Gaast et al, 1994;Doweck et al, 1995). According to our findings, re-elevation of the marker had a positive predictive value of 75% (10 cases of recurrence, 2 deaths, 4 NED).…”

Section: Discussionsupporting

confidence: 68%

“…Our preliminary data showed high levels of Cyfra 21-1 in HNSCC (Doweck et al, 1995). The sensitivity of the marker in nasopharyngeal carcinoma was found to be 58.3% (Yen et al, 1998).…”

Section: Discussionmentioning

confidence: 56%

“…The sensitivity and specificity of the marker were 60% and 94%, respectively. Positive and negative predictive values were 75% and 89% (Doweck et al, 1995).…”

mentioning

confidence: 94%

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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

et al. 2000

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Summary 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 ≥ 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.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionsupporting

confidence: 68%

“…Our preliminary data showed high levels of Cyfra 21-1 in HNSCC (Doweck et al, 1995). The sensitivity of the marker in nasopharyngeal carcinoma was found to be 58.3% (Yen et al, 1998).…”

Section: Discussionmentioning

confidence: 56%

“…The sensitivity and specificity of the marker were 60% and 94%, respectively. Positive and negative predictive values were 75% and 89% (Doweck et al, 1995).…”

mentioning

confidence: 94%

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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

et al. 2000

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“…The best results were logically obtained in adenocarcinomas since serum CA 15-3 is proposed for the management of breast adenocarcinomas (Soletormos et al, 1996), CA 72-4 for gastric and ovarian adenocarcinomas (Guadagni et al, 1995) and CA 19-9 for digestive adenocarcinomas (Grem, 1997). CYFRA 21-1, a serum assay for soluble fragments of cytokeratin 19, was recently proposed for the diagnosis and the follow-up of non-small-cell lung carcinomas (Pujol et al, 1993;Plebani et al, 1995) but also for squamous cell carcinomas of the head and neck (Doweck et al, 1995) and uterine cervix (Callet et al, 1998) and lastly in bladder cancer (Morita et al, 1997). Moreover, we recently described high values of this marker in the pleural fluid of patients with mesothelioma (Salama et al, 1998).…”

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confidence: 99%

Evaluation of seven tumour markers in pleural fluid for the diagnosis of malignant effusions

et al. 1999

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Summary Carcinoembryonic antigen (CEA), carbohydrate antigens , cytokeratin 19 fragments (CYFRA 21-1), neuron-specific enolase (NSE) and squamous cell carcinoma antigen (SCC) were evaluated in pleural fluid for the diagnosis of malignant effusions. With a specificity of 99%, determined in a series of 121 benign effusions, the best individual diagnostic sensitivities in the whole series of 215 malignant effusions or in the subgroup of adenocarcinomas were observed with CEA, CA 15-3 and CA 72-4. As expected, a high sensitivity was obtained with SCC in squamous cell carcinomas and with NSE in small-cell lung carcinomas. CYFRA and/or CA 15-3 were frequently increased in mesotheliomas. Discriminant analysis showed that the optimal combination for diagnosis of nonlymphomatous malignant effusions was CEA + CA 15-3 + CYFRA + NSE: sensitivity of 94.4% with an overall specificity of 95%. In malignant effusions with a negative cytology, 83.9% were diagnosed using this association. The association CYFRA + NSE + SCC was able to discriminate adenocarcinomas from small-cell lung cancers. Regarding their sensitivity and their complementarity, CEA, CA 15-3, CYFRA 21-1, NSE and SCC appear to be very useful to improve the diagnosis of malignant pleural effusions.

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Early diagnosis and treatment monitoring roles of tumor markers Cyfra 21-1 and TPS in oral squamous cell carcinoma

Nagler

Barak²,

Peled

et al. 1999

Cancer

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BACKGROUND Mucosal oral squamous cell carcinoma (SCC) accounts for 3–5% of all reported cancers, with a 5‐year survival rate of approximately 50%. Unfortunately, current detection means are of no value in diagnosing lesions early enough for cure, especially when they recur after resection. Postoperative radiotherapy and/or covering the resection site with reconstructive flaps (regional or free vascularized) often makes early diagnosis an impossible task. METHODS The authors examined the detection and treatment monitoring capacity of two relatively new tumor markers in the serum of SCC patients, comparing their levels with those in patients with other oral/perioral malignancies or benign oral tumors and with disease free, posttreatment SCC patients and healthy controls. RESULTS Values of sensitivity, specificity, and positive and negative prediction for Cyfra 21‐1 were 96%, 87%, 93%, and 53%, respectively, whereas those for tissue polypeptide specific antigen (TPS) were 69%, 87%, 93%, and 54%, respectively. Approximately 2–3 weeks after resection of the SCC lesion, Cyfra 21‐1 and TPS levels were reduced by 47% (P ≤ 0.003) and 36% (P ≤ 0.041), respectively. Cyfra 21‐1 levels in SCC patients were significantly greater than those of healthy patients by 73% (P ≤ 0.0001), patients with benign tumors by 74% (P ≤ 0.0003), and patients in disease remission by 66% (P ≤ 0.0002). Similarly, the TPS levels of SCC patients were significantly greater than those of healthy patients by 59% (P ≤ 0.0005), patients with benign tumors by 55% (P ≤ 0.0001), and patients in disease remission by 59% (P ≤ 0.0001). In two patients, a second, new SCC lesion was diagnosed within the follow‐up period, with increased tumor markers noted concomitantly with the diagnosis. CONCLUSIONS The accumulated data point to the suitability of the clinical usage of these two markers, especially Cyfra 21‐1, in the early detection of oral SCC lesions (primary, recurrent, or secondary) as well as for treatment monitoring. These results may open new avenues for the diagnosis and follow‐up of these patients and hopefully improve their treatment outcome. Cancer 1999;85:1018–25. © 1999 American Cancer Society.

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Cyfra 21-1: A New Potential Tumor Marker for Squamous Cell Carcinoma of Head and Neck

Cited by 68 publications

References 13 publications

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

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

Evaluation of seven tumour markers in pleural fluid for the diagnosis of malignant effusions

Early diagnosis and treatment monitoring roles of tumor markers Cyfra 21-1 and TPS in oral squamous cell carcinoma

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