title: Clinical significance of serum cytokeratin-19 fragment (CYFRA 21-1) in hepatocellular carcinoma.
abstract: OBJECTIVE
  CYFRA 21-1, a soluble fragment of cytokeratin 19, is increased in serum in some patients with hepatocellular carcinoma, but the clinical significance of this increase is still unknown.
  
  
  METHODS
  Serum concentrations of CYFRA 21-1 were measured in 240 patients with hepatocellular carcinoma prior to hepatic resection. The relationships between serum CYFRA 21-1 concentrations and clinicopathologic features were analyzed.
  
  
  RESULTS
  The sensitivity of CYFRA 21-1 as a test for hepatocellular carcinoma was 18.8%. Serum CYFRA 21-1 was significantly higher in patients with portal vein tumor thrombus, and serum CYFRA 21-1 increased with the progression of portal vein tumor thrombus. Tumor size was related to serum CYFRA 21-1, but there were no significant correlations between serum CYFRA 21-1 concentrations and tumor differentiation or number of tumors. Although patients with stage IV tumor had significantly higher CYFRA 21-1 concentrations than those with stages I, II, and III, CYFRA 21-1 was not associated with postoperative prognosis.
  
  
  CONCLUSIONS
  Although high concentrations of CYFRA 21-1 were often detected in patients with a tumor diameter greater than 5 cm or tumor thrombus in the major portal vein, CYFRA 21-1 is not a useful diagnostic tool for hepatocellular carcinoma because of its low sensitivity.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamazaki
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
authors.forename: Hiromu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Shogo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Seikan
authors.initials: S
authors.lastname: Hai
authors.forename: Koichi
authors.initials: K
authors.lastname: Ono
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D053539:Keratin-19; D007633:Keratins / Q000097:blood*; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; C102012:antigen CYFRA21.1; D007633:Keratins