CYFRA-21-1 IN MONITORING CERVICAL-CANCER - A COMPARISON WITH TISSUE POLYPEPTIDE ANTIGEN AND SQUAMOUS-CELL-CARCINOMA ANTIGEN

Cyfra 21-1, measuring serum fragments of cytokeratin 19, has been foun d to be related to tumour stage and tumour size in patients with cervi cal cancer and suggested to be a promising marker in squamous cell kin g cancer: We compared the value of this new marker with tissue polypep tide antigen (TPA) and squamous cell carcinoma antigen (SCC-Ag) in mon itoring 30 patients with squamous cell cervical cancer. Serum levels o f each marker were studied in relation to tumour stage and clinical st atus of the patient. The clinical performance of the various assays to separate those patients with complete remission from those patients w ith the presence of tumour (i.e., partial remission, stable disease, o r progressive disease) was assessed by their receiver operating charac teristic (ROC) curves. We found that tumour stage was a prognostic fac tor for survival (p=0.02). Pretreatment serum Cyfra 21-1, TPA, and SCC -Ag levels were not related to stage of disease and were not found to be predictive of survival. In contrast, an elevated post-treatment ser um SCC-Ag level was associated with a poor survival rate (p=0.03). Suc h a relation was not found for Cyfra 21-1 or TPA. The clinical perform ance of post-treatment serum SCC-Ag levels in predicting the presence of tumour was better than the Cyfra 21-1 or TPA assays. This is shown by the left uppermost position of the ROC curve for SCC-Ag. We conclud ed that SCC-Ag appeared to be a better parameter than Cyfra 21-1 and T PA in predicting the presence of tumour during follow-up and survival of patients with cervical cancer.