Li Liang, Liu Guangping, Jin Kai, Lu Honglue, Zhai Xiang, Zhou Mengqian, Yue Kai, Duan Yuansheng, Wu Yansheng, Wang Xudong
Department of Maxillofacial & E.N.T Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Departmentof Otolaryngology, Tianjin Children's Hospital, Tianjin University Children's Hospital, Tianjin, China.
Ann Transl Med. 2020 Oct;8(20):1302. doi: 10.21037/atm-20-6124.
Oropharyngeal squamous cell carcinoma (OPSCC) is a kind of squamous cell carcinoma of head and neck, and its incidence is on the rise in recent years. A variety of prognostic markers for OPSCC have been reported in many studies, but they are expensive or difficult to obtain. So, we retrospectively studied the prognostic significance of cytokeratin 19 soluble fragment (Cyfra21-1) in patients with OPSCC, in order to provide theoretical basis for accurate prognosis assessment.
A retrospective analysis of the clinicopathological data of 85 OPSCC patients with concurrent radiotherapy and chemotherapy (CRT) admitted from January 2010 to June 2017. Serum Cyfra21-1 levels were measured before treatment. Analyze the relationship between Cyfra21-1 and clinical pathological characteristics of patients. The receiver operating characteristic (ROC) curve was used to calculate the cut-off value of Cyfra21-1. The Cox proportional hazard model was used to conduct univariate and multivariate analysis of related prognostic factors, and to determine the factors related to overall survival (OS) and progression-free survival (PFS).
The cutoff value for Cyfra21-1 was 2.93 ng/mL. The baseline data of patients in different Cyfra21-1 groups were balanced and comparable. In the univariate and multivariate analyses, it was found that Cyfra21-1 was associated with OS and PFS. A measurement of Cyfra21-1 ≥2.93 ng/mL indicated poor OS (P<0.001) and PFS (P=0.001). After adjusting for age and disease stage, Cyfra21-1 can independently affect the OS (HR =3.57, 95% CI: 1.60-7.99, P=0.002) and PFS (HR =2.89, 95% CI: 1.41-5.91, P=0.004) of patients with OPSCC treated with CRT.
Pre-treatment Cyfra21-1 can be used as a prognostic marker for patients with OPSCC treated with CRT, which has important clinical significance.
口咽鳞状细胞癌（OPSCC）是头颈部鳞状细胞癌的一种，近年来其发病率呈上升趋势。许多研究报道了多种OPSCC的预后标志物，但它们昂贵或难以获取。因此，我们回顾性研究细胞角蛋白19可溶性片段（Cyfra21-1）在OPSCC患者中的预后意义，以便为准确的预后评估提供理论依据。
回顾性分析2010年1月至2017年6月收治的85例接受同步放化疗（CRT）的OPSCC患者的临床病理资料。在治疗前检测血清Cyfra21-1水平。分析Cyfra21-1与患者临床病理特征之间的关系。采用受试者工作特征（ROC）曲线计算Cyfra21-1的截断值。采用Cox比例风险模型对相关预后因素进行单因素和多因素分析，确定与总生存期（OS）和无进展生存期（PFS）相关的因素。
Cyfra21-1的截断值为2.93 ng/mL。不同Cyfra21-1组患者的基线数据均衡且具有可比性。在单因素和多因素分析中，发现Cyfra21-1与OS和PFS相关。Cyfra21-1≥2.93 ng/mL表明OS（P<0.001）和PFS（P=0.001）较差。在调整年龄和疾病分期后，Cyfra21-1可独立影响接受CRT治疗的OPSCC患者的OS（HR =3.57，95%CI：1.60-7.99，P=0.002）和PFS（HR =2.89，95%CI：1.41-5.91，P=0.004）。
治疗前Cyfra21-1可作为接受CRT治疗的OPSCC患者的预后标志物，具有重要的临床意义。
