title: Urine and serum concentrations of Cytokeratin 19 in preeclampsia.
abstract: OBJECTIVE
  To evaluate the usefulness of Cytokeratin 19 as biomarker for the diagnosis of preeclampsia.
  
  
  METHODS
  Cytokeratin 19 protein fragment CYFRA 21-1 was measured by means of electrochemiluminescence immunoassays in urine and serum samples of 32 women with preeclampsia and 32 samples of normotensive healthy singleton pregnancies at random, matched for gestational age, as controls.
  
  
  RESULTS
  The median serum concentrations of CYFRA 21-1 in controls and women with preeclampsia were 2.4 (range 1.3-6.6)ng/mL and 4.4 (range 2.1-16.2)ng/mL, respectively (p<0.001). The median urine concentrations of CYFRA 21-1 in controls and women with preeclampsia were 13.7 (range 0.7-441.4)ng/mL and 11.8 (range 1.5-338.6)ng/mL, respectively (p=0.629). Calculation of a ROC curve to study the use of serum CYFRA 21-1 concentration as a predictor of preeclampsia revealed cut-off points with the highest sum of specificity and sensitivity of 3.2ng/mL, leading to specificity of 75% and sensitivity of 84%. A similar curve calculated for CYFRA 21-1 in urine showed an area under the curve of 0.536 meaning no predictive power. The correlation between urinary excretion of protein in 24h and serum concentrations of CYFRA 21-1 in the case group was r=0.26, which is not significant (p=0.258). The correlation between proteinuria and urine values of CYFRA 21-1 was r=0.10, which also is not significant (p=0.666).
  
  
  CONCLUSIONS
  Serum levels of Cytokeratin 19 fragment are increased in women with preeclampsia. However this does not result in a significant difference in CYFRA 21-1 levels in maternal urine. Thus Cytokeratin 19 fragment may prove to be a valuable biomarker for preeclampsia in serum but not urine. We propose further longitudinal studies to investigate the role of Cytokeratin 19 in maternal serum of women with preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Kuessel
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Wild
authors.affiliation: Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Helmuth
authors.initials: H
authors.lastname: Haslacher
authors.affiliation: Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Perkmann
authors.affiliation: Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria.
authors.forename: Robin
authors.initials: R
authors.lastname: Ristl
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Harald
authors.initials: H
authors.lastname: Zeisler
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria. Electronic address: maximilian.schmid@medunwien.ac.at.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Schmid
mesh_terms: D000328:Adult; D000951:Antigens, Neoplasm / Q000097:blood* / Q000652:urine*; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000097:blood* / Q000652:urine*; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis / Q000652:urine*; D011247:Pregnancy; D012372:ROC Curve; D055815:Young Adult
chemical_list: D000951:Antigens, Neoplasm; D015415:Biomarkers; D053539:Keratin-19; C102012:antigen CYFRA21.1
keywords: Biomarker; Cytokeratin; Preeclampsia; Urine