Banal A, Hacene K, Berthelot-Ruff E, Mahé E, Fontana X, Pichon M F
Service d'Oto-Rhino-Laryngologie, Centre René Huguenin de Lutte Contre le Cancer, Saint-Cloud, France.
Tumour Biol. 2001 Jan-Feb;22(1):27-35. doi: 10.1159/000030152.
Patients with head and neck tumours (HNT) have a high risk of early locoregional relapse that is difficult to diagnose. This study evaluated the usefulness of the serum Cyfra 21-1 assay compared to squamous cell carcinoma antigen (SCC) assay for monitoring such patients. Three hundred and twelve HNT patients, including 204 newly diagnosed patients, were followed up for a median of 446 days with serial serum assays for SCC and Cyfra 21-1. Untreated patients showed SCC and Cyfra 21-1 serum levels correlated with each other: concentration was correlated to clinical stage, tumour size (as T1 + T2 vs. T3 + T4) and nodal status. Cyfra 21-1, but not SCC, was related to the presence of metastases and the primary tumour site, with a univariate prognostic value for disease-free survival (p = 0.015). Cox's regression analysis showed that only Cyfra 21-1 was associated with a risk of relapse (p = 0.027). The random coefficient growth curve model applied to serial SCC and Cyfra 21-1 measurements of 111 patients showed that only Cyfra 21-1 exhibited a significant difference between patients with and without relapses. We found Cyfra 21-1 to be more closely related to initial clinical data and disease evolution than SCC, and therefore propose the use of Cyfra 21-1 for monitoring head and neck cancers.
头颈部肿瘤（HNT）患者早期局部区域复发风险高且难以诊断。本研究评估了血清细胞角蛋白19片段（Cyfra 21-1）检测相较于鳞状细胞癌抗原（SCC）检测在监测此类患者方面的实用性。312名头颈部肿瘤患者，包括204名新诊断患者，接受了中位时间为446天的随访，期间对SCC和Cyfra 21-1进行了系列血清检测。未经治疗的患者中，SCC和Cyfra 21-1血清水平相互关联：浓度与临床分期、肿瘤大小（如T1 + T2与T3 + T4）及淋巴结状态相关。Cyfra 21-1而非SCC与转移灶的存在及原发肿瘤部位有关，对无病生存期具有单因素预后价值（p = 0.015）。Cox回归分析显示，只有Cyfra 21-1与复发风险相关（p = 0.027）。应用于111名患者系列SCC和Cyfra 21-1测量值的随机系数生长曲线模型表明，只有Cyfra 21-1在复发和未复发患者之间存在显著差异。我们发现Cyfra 21-1比SCC与初始临床数据及疾病进展的关系更为密切，因此建议使用Cyfra 21-1来监测头颈部癌症。
