CYFRA 21-1 - A NEW POTENTIAL TUMOR-MARKER FOR SQUAMOUS-CELL CARCINOMAOF HEAD AND NECK

Objective: Evaluation of Cyfra 21-1 (cytokeratin fraction 21-1) in squ amous cell carcinoma of the head and neck: Design: Prospective study. Patients: Serum Cyfra 21-1 concentration was measured in 250 samples f rom patients with squamous cell carcinoma of head and neck, patients w ith benign tumors of head and neck, healthy control subjects, and pati ents in remission from squamous cell carcinoma of head and neck. Resul ts: Cyfra 21-1 concentration was elevated in 60% of the new patients w ith squamous cell carcinoma but only in 8% of patients with benign tum ors and 3.5% of the healthy controls. At a cutoff of 1.3 ng/mL, the se nsitivity of the test was 60%, the specificity was 94%, positive predi ctive value was 75%, and negative predictive value was 89%. The marker levels tended to follow the clinical course of the disease and were u seful for therapy monitoring. Cyfra 21-1 levels were in good correlati on with the tumor stage expressed by the local (T) and the lymphatic s pread (N) and were inversely correlated with histologic grade, eg, hig her in poorly differentiated carcinoma than in well-differentiated squ amous cell carcinoma. Conclusion: Cyfra 21-1 evaluation in head and ne ck squamous cell carcinoma is worthwhile for performance of an ample s tudy that will prove and establish its routine use.