CYFRA-21-1 SERUM LEVELS IN WOMEN WITH ADNEXAL MASSES AND INFLAMMATORYDISEASES

The aim of the present study was to evaluate the clinical usefulness o f the cytokeratin marker CYFRA 21-1 as a screening marker for ovarian cancer, as a predictive marker in patients with adnexal masses and as a prognostic marker in women suffering from ovarian cancer. In order t o determine the specificity of the CYFRA 21-1 test, we have investigat ed CYFRA 21-1 serum levels in several benign conditions. This retrospe ctive study comprises 37 patients suffering from ovarian cancer FIGO s tages la-lll, Sera from patients with benign ovarian cysts, endometrio sis, pelvic inflammatory disease, inflammatory bowel disease and liver cirrhosis were evaluated in 90, 10, 38, 10 and 20 cases respectively. With a sensitivity of 41% and a specificity of 95%, CYFRA 21-1 was no t suitable as a screening marker for ovarian cancer. Although CYFRA 21 -1 was able to discriminate between ovarian cancer and benign adnexal tumours (univariate regression model, P=0.0001), CYFRA 21-1 did not re veal additional information to CA 125 in a multivariate regression ana lysis (P=0.06), CYFRA 21-1 serum levels were elevated in benign condit ions such as liver cirrhosis, but not in endometriosis and inflammator y diseases. In ovarian cancer patients, elevated CYFRA 21-1 serum leve ls before therapy were associated with a poor overall and disease-free survival (log-rank test, P=0.02 and log-rank test, P=0.005 respective ly). CYFRA 21-1, while obviously not suitable for screening or differe ntial diagnosis of adnexal masses, could be useful as an additional pr ognostic factor in ovarian cancer patients.