CLINICAL RELEVANCE OF CYFRA-21-1, TPA-IRMA AND TPA-LIA-MAT IN URINARY-BLADDER CANCER

The sera of 154 cancer patients were analyzed at primary diagnosis bef ore any therapy to find out the clinical importance of CYFRA 21-1 (det ecting cytokeratin 19-fragments) compared with the polyclonal TPA-IRMA and the monoclonal TPA-LIA-mat-assay (both measuring fragments of cyt okeratin 8, 18 and 19). The reference group consisted of 100 healthy p ersons as well as 78 patients with exclusively benign urological disea ses. We defined the cut-off values based on 95% specificity versus ben ign urological disorders. For CYFRA 21-1 the cut-off value was found t o be 2.5 ng/mL, for TPA-IRMA 165 U/L and for TPA-LIA-mat 136 U/L. Taki ng into account all stages CYFRA 21-1 showed a sensitivity of 31% vers us 20% and 16% for TPA-IRMA and TPA-LIA-mat, respectively. Considering only the muscle invasive carcinomas 52% sensitivity for CYFRA 21-1 vs . 39% and 33% for TPA-IRMA and TPA-LIA-mat could be found. All three m arkers correlate with the stage of disease, CYFRA 21-1 to the highest degree (stage 0: 16%, stage IV: 71%). CYFRA 21-1 shows the best sensit ivity-specificity-profile and seems to be a recommendable marker for t he follow-up of urinary bladder cancers, except for the Ta- tumours wh ich only rarely develop into muscle invasive cancers.