CYFRA 21.1 in Patients with Cervical Cancer: Comparison with SCC and CEA

• Published in: Anticancer research Vol. 25; no. 3A; pp. 1765 - 1771
• Main Authors: MOLINA, Rafael, FILELLA, Xavier, BIETE, Albert, AUGE, Jose M, BOSCH, Elvira, TORNE, Aureli, PAHISA, Jaume, LEJARCEGUI, Jose A, ROVIROSA, Angels, MELLADO, Begona, ORDI, Jaume
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01-05-2005
• Subjects: Antigens, Neoplasm - blood; Biological and medical sciences; Biomarkers, Tumor - blood; Carcinoembryonic Antigen - blood; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Keratin-19; Keratins; Medical sciences; Prospective Studies; Sensitivity and Specificity; Serpins - blood; Tumors; Uterine Cervical Neoplasms - blood; Human; SCC; Cancerology; Prognosis; tumor markers; Tumoral marker; Malignant tumor; Uterine cervix diseases; Cervical cancer; Comparative study; CEA; Female genital diseases
• ISSN: 0250-7005; 1791-7530

The serum levels of CYFRA 21.1, CEA and SCC were prospectively determined in 156 patients diagnosed with carcinoma of the
uterine cervix from 1995 to 2003. Histology revealed squamous cancer in 119 patients, adenocarcinoma in 25 patients and adenosquamous
carcinoma in the remaining 12 patients. We considered 3.3 ng/ml, 5 ng/ml and 2 ng/ml as the upper limits of normality for
CYFRA 21.1, CEA and SCC, respectively. The sensitivity of CYFRA 21.1, CEA and SCC was 26%, 25% and 43%, respectively, at diagnosis.
SCC was clearly related to tumor histology, with significantly higher levels in squamous tumors than in other histological
types (p<0.0001). The relationship of CEA with the histological type was poor, but the highest concentrations were found in
adenocarcinomas (p=0.034). All the tumor markers were related to well known prognostic factors such as tumor size, tumor stage,
parametrial invasion and nodal involvement. Abnormal pretreatment serum levels indicated a high probability (>83%) of parametrial
invasion in squamous tumors. Likewise, pretreatment SCC and CYFRA 21.1 serum levels were of prognostic value, with a shorter
DFS and OS in patients with abnormal levels. Multivariate analysis indicated that stage, histological grade and parametrial
invasion were independent prognostic factors, but not tumor markers. In conclusion, SCC is the tumor marker of choice in squamous
tumors and the addition of CEA or CYFRA 21.1 does not significantly increase the sensitivity obtained by using SCC alone.