CLINICAL-VALUE OF PRETREATMENT SERUM CYFRA-21-1, TISSUE POLYPEPTIDE ANTIGEN, AND SQUAMOUS-CELL CARCINOMA ANTIGEN LEVELS IN PATIENTS WITH CERVICAL-CANCER

Background, The clinical value of pretreatment serum concentrations of cytokeratin 19 fragments, measured by Cyfra 21-1, was compared with t issue polypeptide antigen (TPA) and squamous cell carcinoma antigen (S CC-Ag) in 78 patients with squamous cell cervical cancer. Methods. Ser um levels were compared with tumor stage, size, lymph node status, par ametrial involvement, and prognostic data, The clinical performance of the different tests was evaluated by their receiver operating charact eristic (ROC) curves. Results, Serum levels of all markers were relate d significantly to tumor stage and size, Elevated serum levels of thes e markers were not found to be predictive for the presence of lymph no de metastases, In contrast, a positive relation was found between quan titative serum Cyfra 21-1, TPA, and SCC-Ag levels and the presence of either lymph node metastases or parametrial involvement (i,e,, extrace rvical disease), An elevated, i.e, positive, serum Cyfra 21-1 level wa s related significantly to the presence of extracervical disease (P = 0.020), The clinical performance of each serum marker in predicting ly mph node metastases or parametrial involvement appeared to be similar as expressed by their ROC curves, In the univariate analysis, Cyfra 21 -1, TPA, and SCC-Ag showed prognostic value with respect to disease fr ee interval and survival. Elevated serum levels were associated with a poor prognosis, However, after adjusting for tumor stage and size, no ne of these markers remained statistically significant. Conclusions, C yfra 21-1 may be of additional value in assessing stage of disease, tu mor size, and the presence of extracervical disease in patients with c ervical cancer. Determining its value during follow-up warrants furthe r study.