Department of Otolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043, Marburg, Germany.
Department of Otolaryngology, Head/Neck and Facial Plastic Surgery, Sana Kliniken Leipziger Land, Borna, Germany.
Eur Arch Otorhinolaryngol. 2020 Sep;277(9):2561-2571. doi: 10.1007/s00405-020-05962-4. Epub 2020 Apr 13.
The role of Cytokeratin fraction 21-1 (CYFRA 21-1) as a tumour marker for head and neck cancer is still a matter of research. The aim of the present study was to evaluate the clinical impact of CYFRA 21-1 for patients with oropharyngeal squamous cell carcinoma (OSCC).
Data of 180 patients with an initial diagnosis of OSCC of any stage between 2003 and 2017 were retrospectively analysed regarding the association between pretherapeutic CYFRA 21-1 levels, clinical characteristics, overall and disease-free survival. Additionally, the potential of CYFRA 21-1 for the detection of recurrent disease in the follow-up was evaluated. The cut-off value was set at 3.3 ng/ml. The median follow-up time was 2.85 years.
A significant correlation of the CYFRA 21-1 concentration at the time of diagnosis and the N-stage was detected (p = 0.01). Patients with CYFRA 21-1 levels > 3.3 ng/ml at first diagnosis showed a significantly shorter overall survival. In the case of disease-progression, a significant increase of CYFRA 21-1 value was found compared to post-therapeutic CYFRA 21-1 levels (9.1 ng/ml versus 5.1 ng/ml; p < 0.01). CYFRA 21-1 level after treatment showed only a low sensitivity of 32% and a specificity of 78% for tumour recurrence.
CYFRA 21-1 correlates with the tumour stage and, therefore, the survival of OSCC patients. Posttreatment CYFRA21-1 seems not to be a suitable predictor of tumour recurrence in the further course of the disease. However, a sudden increase of CYFRA 21-1 during follow-up may indicate a tumour recurrence in the individual patient.
细胞角蛋白 21-1（CYFRA 21-1）作为头颈部癌症肿瘤标志物的作用仍在研究之中。本研究旨在评估 CYFRA 21-1 对初诊为口咽鳞状细胞癌（OSCC）患者的临床影响。
回顾性分析了 2003 年至 2017 年间初诊为任何分期 OSCC 的 180 例患者的数据，以评估治疗前 CYFRA 21-1 水平与临床特征、总生存和无病生存之间的关系。此外，还评估了 CYFRA 21-1 在随访中检测复发疾病的潜力。设定截止值为 3.3ng/ml。中位随访时间为 2.85 年。
在诊断时，CYFRA 21-1 浓度与 N 期有显著相关性（p=0.01）。首次诊断时 CYFRA 21-1 水平>3.3ng/ml 的患者总生存时间明显缩短。在疾病进展的情况下，与治疗后 CYFRA 21-1 水平（9.1ng/ml 与 5.1ng/ml；p<0.01）相比，发现 CYFRA 21-1 值显著升高。治疗后 CYFRA 21-1 水平对肿瘤复发的敏感性仅为 32%，特异性为 78%。
CYFRA 21-1 与肿瘤分期相关，因此与 OSCC 患者的生存相关。治疗后 CYFRA21-1 似乎不是疾病进一步发展中肿瘤复发的合适预测因子。然而，在随访过程中 CYFRA 21-1 的突然增加可能表明个别患者存在肿瘤复发。
