Study of cyfra 21-1, a tumor marker, in head and neck squamous cell carcinoma.
OBJECTIVE
We performed a prospective study to determine the cutoff value and the prognostic value of Cyfra 21-1, a serum tumor marker, in head and neck squamous cell carcinoma (HNSCC).


METHODS
The serum concentration of Cyfra 21-1 was measured in a group of 300 patients (group 1) with HNSCC, in a control group of 71 healthy subjects (group 2), and in a group of 73 patients with a nonmalignant tumor or inflammatory disease (group 3). The concentrations were compared between the various groups and subgroups; the cutoff value was calculated with a receiver operating characteristic curve. Furthermore, the serum concentrations of Cyfra 21-1 before treatment in the group of 300 patients were compared with the stage of the disease and with the evolution of the overall survival rate and the disease-free survival rate. Finally, to determine whether Cyfra 21-1 is an independent prognostic factor, we compared the concentrations, by a Cox model, with the classic prognostic factors of HNSCC.


RESULTS
At the cutoff value of 1 ng/mL, the specificity was 94% and the sensitivity was 72%. The serum concentrations of Cyfra 21-1 were statistically correlated with the stage of the disease. The overall survival rate and the disease-free survival rate were lower in patients with high serum concentrations, and these differences were statistically significant (p < .001). The Cox model allows us to conclude that Cyfra 21-1 is a prognostic marker that is independent of other classic prognostic factors.


CONCLUSIONS
Cyfra 21-1 is an interesting tumor marker that could be proposed for the early detection of HNSCC with a cutoff value of 1 ng/mL. Furthermore, Cyfra 21-1 can be considered an independent prognostic marker.
Céruse
Philippe
P
Departments of Otolaryngology-Head and Neck Surgery, Lyon-Sud Hospital, Pierre Bénite, France.
Rabilloud
Muriel
M
Charrié
Anne
A
Dubreuil
Christian
C
Disant
François
F
D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000401:mortality; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000097:blood; D053539:Keratin-19; D007633:Keratins; D007822:Laryngeal Neoplasms / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009959:Oropharyngeal Neoplasms / Q000097:blood; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; C102012:antigen CYFRA21.1; D007633:Keratins