Abstract
The Cyfra 21.1 assay is a newly developed test which measures in serum a fragment of cytokeratin 19. We evaluated this marker in 212 patients with non-small-cell lung cancer (NSCLC), predominantly stage 3a-b and 4, and compared it with three other markers: carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and tissue polypeptide antigen (TPA). Sensitivities for Cyfra 21.1, TPA, CEA and SCC (using cut-off levels corresponding to a 95% specificity for benign lung diseases) were 40%, 40%, 42% and 19% respectively. The sensitivity of CEA was significantly higher in patients with adenocarcinomas compared with the other three markers, while the sensitivity of Cyfra 21.1 and TPA was significantly higher in patients with squamous cell carcinomas. The value of Cyfra 21.1 for monitoring disease during chemotherapy could be evaluated in 23 patients with squamous cell carcinomas. When the cases of lead time were included a concordance between clinical evaluations according to WHO response criteria and evaluations according to changes in the marker levels of 74% was found. The criteria defined for marker response were a 65% decrease in the marker level for a partial response and a 40% increase for progressive disease. In particular, increasing levels of this marker indicated usually disease progression. In conclusion, Cyfra 21.1 is a useful serum marker for patients with NSCLC, especially for disease monitoring of patients with squamous cell carcinoma during and after chemotherapy.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bac D. J., Kok T. C., van der Gaast A., Splinter T. A. Evaluation of CA19-9 serum levels for monitoring disease activity during chemotherapy of pancreatic adenocarcinoma. J Cancer Res Clin Oncol. 1991;117(3):263–265. doi: 10.1007/BF01625436. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bartek J., Taylor-Papadimitriou J., Miller N., Millis R. Patterns of expression of keratin 19 as detected with monoclonal antibodies in human breast tissues and tumours. Int J Cancer. 1985 Sep 15;36(3):299–306. [PubMed] [Google Scholar]
- Bates S. E. Clinical applications of serum tumor markers. Ann Intern Med. 1991 Oct 15;115(8):623–638. doi: 10.7326/0003-4819-115-8-623. [DOI] [PubMed] [Google Scholar]
- Geiger B. Intermediate filaments. Looking for a function. Nature. 1987 Oct 1;329(6138):392–393. doi: 10.1038/329392a0. [DOI] [PubMed] [Google Scholar]
- Moll R., Franke W. W., Schiller D. L., Geiger B., Krepler R. The catalog of human cytokeratins: patterns of expression in normal epithelia, tumors and cultured cells. Cell. 1982 Nov;31(1):11–24. doi: 10.1016/0092-8674(82)90400-7. [DOI] [PubMed] [Google Scholar]
- Pujol J. L., Grenier J., Daurès J. P., Daver A., Pujol H., Michel F. B. Serum fragment of cytokeratin subunit 19 measured by CYFRA 21-1 immunoradiometric assay as a marker of lung cancer. Cancer Res. 1993 Jan 1;53(1):61–66. [PubMed] [Google Scholar]
- Souquet P. J., Chauvin F., Boissel J. P., Cellerino R., Cormier Y., Ganz P. A., Kaasa S., Pater J. L., Quoix E., Rapp E. Polychemotherapy in advanced non small cell lung cancer: a meta-analysis. Lancet. 1993 Jul 3;342(8862):19–21. doi: 10.1016/0140-6736(93)91882-m. [DOI] [PubMed] [Google Scholar]
- Stasiak P. C., Purkis P. E., Leigh I. M., Lane E. B. Keratin 19: predicted amino acid sequence and broad tissue distribution suggest it evolved from keratinocyte keratins. J Invest Dermatol. 1989 May;92(5):707–716. doi: 10.1111/1523-1747.ep12721500. [DOI] [PubMed] [Google Scholar]