SERUM CYFRA-21-1 IN THE ASSESSMENT OF EPITHELIAL CANCERS

CYFRA 21-1, a fragment of cytokeratin 19, is expressed in epithelia as well as in their malignant counterpart. This fragment is detected in serum by means of IRMA and ELISA methods and may be useful in the asse ssment of patient with neoplasias of epithelial origin. We here evalua ted the clinical utility of CYFRA 21-1, determined by an ELISA method, in the diagnosis of lung cancer (25 patients), gastric cancer (19 pat ients) and colon cancer (20 patients). To ascertain the specificity of this test, we made a comparative study, using patients with benign lu ng diseases, peptic ulcer, benign gastrointestinal and hepatobiliary d iseases (37, 27, 15 and 19 cases respectively) as controls. Considerin g a cutoff value of 3.2 ug/L sensitivity of CYFRA 21-1 in diagnosing l ung, gastric and colon cancers were: 52%, 33% and 25%; specificities t owards benign lung, gastric and intestinal diseases were 86%, 92% and 90% respectively. CYFRA 21-1 did not vary in relation to the stage of the studied tumors, while it was correlated with some indices of chole stasis (total bilirubin and GGT) and with C reactive protein. In concl usion, CYFRA 21-1 may be considered a useful serum index of lung cance r, but not of gastric or colon cancer; however it must be cautiously e valuated when cholestasis or inflammation is present, since they may c ontribute in enhancing its serum levels.