Prognostic value of the serum tumour markers Cyfra 21-1 and tissue polypeptide antigen in malignant mesothelioma

In malignant mesothelioma, survival is claimed to be related to age, durati on of symptoms, performance status, histological subtype, stage and platele t count. However the exact prognostic value of these factors is still a mat ter of debate. We studied the two cytokeratin markers, Cyfra 21-1 and Tissu e polypeptide antigen (TPA) for their significance in predicting survival r etrospectively in 52 patients. Cyfra 21-1 and TPA were elevated in 26 (50%) and 30 (58%) patients, respectively, and were highly correlated (r = 0.98) . Univariate analysis of data from 51 patients, showed a relation with surv ival for performance status (P = 0.010), thoracic pain (P = 0.014), platele t count (P = 0.027), Cyfra 21-1 (P = 0.002) and TPA (P = 0.003). Multivaria te analysis identified independent prognostic significance for performance status, platelet count and Cyfra 21-1. In addition to performance status (< 80 vs. >80) the cytokeratin markers identified patients with good prognosis in a log rank test. Values of Cyfra 21-1 and TPA are significantly correla ted. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.