title: CYFRA 21-1 serum levels in women with adnexal masses and inflammatory diseases.
abstract: The aim of the present study was to evaluate the clinical usefulness of the cytokeratin marker CYFRA 21-1 as a screening marker for ovarian cancer, as a predictive marker in patients with adnexal masses and as a prognostic marker in women suffering from ovarian cancer. In order to determine the specificity of the CYFRA 21-1 test, we have investigated CYFRA 21-1 serum levels in several benign conditions. This retrospective study comprises 37 patients suffering from ovarian cancer FIGO stages Ia-III. Sera from patients with benign ovarian cysts, endometriosis, pelvic inflammatory disease, inflammatory bowel disease and liver cirrhosis were evaluated in 90, 10, 38, 10 and 20 cases respectively. With a sensitivity of 41% and a specificity of 95%, CYFRA 21-1 was not suitable as a screening marker for ovarian cancer. Although CYFRA 21-1 was able to discriminate between ovarian cancer and benign adnexal tumours (univariate regression model, P = 0.0001), CYFRA 21-1 did not reveal additional information to CA 125 in a multivariate regression analysis (P = 0.06). CYFRA 21-1 serum levels were elevated in benign conditions such as liver cirrhosis, but not in endometriosis and inflammatory diseases. In ovarian cancer patients, elevated CYFRA 21-1 serum levels before therapy were associated with a poor overall and disease-free survival (log-rank test, P = 0.02 and log-rank test, P = 0.005 respectively). CYFRA 21-1, while obviously not suitable for screening or differential diagnosis of adnexal masses, could be useful as an additional prognostic factor in ovarian cancer patients.
authors.affiliation: Department of Gynaecology and Obstetrics, University of Vienna Medical School, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Tempfer
authors.forename: L
authors.initials: L
authors.lastname: Hefler
authors.forename: H
authors.initials: H
authors.lastname: Heinzl
authors.forename: A
authors.initials: A
authors.lastname: Loesch
authors.forename: G
authors.initials: G
authors.lastname: Gitsch
authors.forename: H
authors.initials: H
authors.lastname: Rumpold
authors.forename: C
authors.initials: C
authors.lastname: Kainz
mesh_terms: D000291:Adnexal Diseases / Q000097:blood*; D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D053539:Keratin-19; D007633:Keratins; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood*; D000292:Pelvic Inflammatory Disease / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; C102012:antigen CYFRA21.1; D007633:Keratins