Bonfrer J M, Gaarenstroom K N, Korse C M, Van Bunningen B N, Kenemans P
Department of Clinical Chemistry, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Anticancer Res. 1997 May-Jun;17(3C):2329-34.
Cyfra 21-1, measuring serum fragments of cytokeratin 19, has been found to be related to tumor stage and tumour size in patients with cervical cancer and suggested to be a promising marker in squamous lung cancer. We compared the value of this new marker with tissue polypeptide antigen (TPA) and squamous cell carcinoma antigen (SCC-Ag) in monitoring 30 patients with squamous cell cervical cancer. Serum levels of each marker were studied in relation to tumour stage and clinical status of patient. The clinical performance of the various assays to separate those patients with complete remission from those patients with the presence of tumour (i.e., partial remission, stable disease, or progressive disease) was assessed by their receiver operating characteristic (ROC) curves. We found that tumour stage was a prognostic factor 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 serum SCC-Ag level was associated with a poor survival rate (p = 0.03). Such a relation was not found for Cyfra 21-1 or TPA. The clinical performance 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 concluded that SCC-Ag appeared to be a better parameter than Cyfra 21-1 and TPA in predicting the presence of tumour during follow-up and survival of patients with cervical cancer.
细胞角蛋白19片段（Cyfra 21-1）用于检测血清中的细胞角蛋白19片段，已发现其与宫颈癌患者的肿瘤分期及肿瘤大小相关，并且被认为是鳞状细胞肺癌中有前景的标志物。我们比较了这一新标志物与组织多肽抗原（TPA）及鳞状细胞癌抗原（SCC-Ag）在监测30例宫颈鳞状细胞癌患者中的价值。研究了每种标志物的血清水平与肿瘤分期及患者临床状态的关系。通过各检测方法的受试者工作特征（ROC）曲线评估其区分完全缓解患者与仍有肿瘤患者（即部分缓解、病情稳定或病情进展）的临床性能。我们发现肿瘤分期是生存的一个预后因素（p = 0.02）。治疗前血清Cyfra 21-1、TPA和SCC-Ag水平与疾病分期无关，也未发现其可预测生存情况。相比之下，治疗后血清SCC-Ag水平升高与生存率低相关（p = 0.03）。Cyfra 21-1或TPA未发现有此类关系。治疗后血清SCC-Ag水平预测肿瘤存在的临床性能优于Cyfra 21-1或TPA检测。这通过SCC-Ag的ROC曲线在最左上方的位置得以体现。我们得出结论，在预测宫颈癌患者随访期间肿瘤的存在及生存情况方面，SCC-Ag似乎是比Cyfra 21-1和TPA更好的参数。
