Premium
CYFRA 21‐1 is a useful marker for esophageal squamous cell carcinoma
Author(s) -
Yamamoto Kohtarou,
Oka Masaaki,
Hayashi Hiroto,
Tangoku Akira,
Gondo Tosikazu,
Suzuki Takashi
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970501)79:9<1647::aid-cncr3>3.0.co;2-9
Subject(s) - cytokeratin , medicine , carcinoembryonic antigen , immunohistochemistry , pathology , staining , tumor marker , carcinoma , univariate analysis , gastroenterology , cancer , multivariate analysis
BACKGROUND CYFRA 21‐1 measures soluble cytokeratin‐19 fragments in serum and is a useful marker for lung carcinoma, especially squamous cell carcinoma (SCC). The authors conducted this study to determine the significance of CYFRA 21‐1 in patients with esophageal SCC. METHODS Expression and production of cytokeratin‐19 in the authors' six established esophageal SCC cell lines were determined by immunocytochemical staining and enzyme‐linked immunoadsorbent assay, respectively. The correlation between serum CYFRA 21‐1 levels and expression of cytokeratin‐19 in human tumors was investigated by immunohistochemical staining. The correlation between serum CYFRA 21‐1 levels and clinicopathologic factors was examined in 48 patients with esophageal SCC, as were SCC antigen and carcinoembryonic antigen (CEA). RESULTS Of the 6 cell lines, 5 lines expressed cytokeratin‐19 in their cytoplasm and produced soluble cytokeratin‐19 fragments. Twenty‐three of 48 patients had elevated CYFRA 21‐1 levels (>3.5 ng/mL), whereas none of the reference group (consisting of healthy volunteers or patients with benign disease) showed positive levels. The specificity, sensitivity, and accuracy of CYFRA 21‐1 were 100%, 47.9%, and 66.7%, respectively. CYFRA 21‐1 showed significantly higher sensitivity and accuracy than SCC antigen or CEA ( P < 0.05). Univariate analysis revealed that CYFRA 21‐1 levels correlated with disease progression (including tumor size, tumor depth, and pTNM stage), resectability, and curability. There was a significant association between the level of CYFRA 21‐1 and its intensity of immunohistochemical staining in vitro as well as in vivo. CONCLUSIONS CYFRA 21‐1 appears to be a useful marker for human squamous cell carcinoma of the esophagus. Cancer 1997; 79:1647‐55. © 1997 American Cancer Society.