Pretreatment serum CYFRA 21-1 level correlates significantly with survival of cervical cancer patients: a multivariate analysis of 506 cases.
OBJECTIVE
To determine whether pretreatment CYFRA 21-1 levels can be a useful prognostic indicator in cervical cancer with reference to squamous cell carcinoma-antigen (SCC-Ag).


METHODS
We retrospectively analyzed data on 506 consecutive cervical cancer patients who were treated by radical hysterectomy or primary concurrent chemoradiation therapy. The pretreatment serum SCC-Ag and serum CYFRA 21-1 levels were measured in these patients. A multivariate analysis using Cox's proportional hazard model was performed to evaluate the prognostic significance of pretreatment variables.


RESULTS
In patients who underwent radical hysterectomy, there was a significant correlation between pretreatment serum SCC-Ag/CYFRA 21-1 levels and patient age, advanced FIGO stage, large tumor size, lymph node metastasis, and deep stromal invasion. In the stepwise Cox regression analysis, large tumor size >4cm was an independent prognostic factor for disease-free survival (OR, 3.110; [95% CI, 1.588-6.093], P=0.001) and overall survival (OR, 8.497; [95% CI, 1.797-40.184], P=0.007) in patients with squamous cell carcinoma, while pretreatment CYFRA 21-1 (P=0.010) serum levels had a significant independent effect on overall survival. Likewise, pretreatment CYFRA 21-1 (P<0.001 and P=0.006) serum levels were the only independent prognostic factor for disease-free survival and overall survival in patients with non-squamous cell carcinoma.


CONCLUSIONS
Pretreatment CYFRA 21-1 levels may be considered as a useful prognostic indicator in cervical cancer with reference to SCC-Ag.
Department of Medical Sciences, The Graduate School, Ajou University, Suwon, South Korea.
Xianling
X
Piao
Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, South Korea.
Tae-Wook
TW
Kong
Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, South Korea. Electronic address: drchang@ajou.ac.kr.
Suk-Joon
SJ
Chang
Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, South Korea.
Jiheum
J
Paek
Gynecologic Cancer Center, Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea.
Mison
M
Chun
Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, South Korea.
Hee-Sug
HS
Ryu
D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000097:blood*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015843:Serpins / Q000097:blood; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy; D055815:Young Adult
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; D015843:Serpins; C102012:antigen CYFRA21.1; C051072:squamous cell carcinoma-related antigen
CYFRA 21-1; Cervical cancer; SCC-Ag; Survival