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Clinical relevance of CYFRA 21-1 as a tumour marker in patients with oropharyngeal squamous cell carcinoma

  • Head and Neck
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Abstract

Background

The role of Cytokeratin fraction 21-1 (CYFRA 21-1) as a tumour marker for head and neck cancer is still a matter of research. The aim of the present study was to evaluate the clinical impact of CYFRA 21-1 for patients with oropharyngeal squamous cell carcinoma (OSCC).

Patients and methods

Data of 180 patients with an initial diagnosis of OSCC of any stage between 2003 and 2017 were retrospectively analysed regarding the association between pretherapeutic CYFRA 21-1 levels, clinical characteristics, overall and disease-free survival. Additionally, the potential of CYFRA 21-1 for the detection of recurrent disease in the follow-up was evaluated. The cut-off value was set at 3.3 ng/ml. The median follow-up time was 2.85 years.

Results

A significant correlation of the CYFRA 21-1 concentration at the time of diagnosis and the N-stage was detected (p = 0.01). Patients with CYFRA 21-1 levels > 3.3 ng/ml at first diagnosis showed a significantly shorter overall survival. In the case of disease-progression, a significant increase of CYFRA 21-1 value was found compared to post-therapeutic CYFRA 21-1 levels (9.1 ng/ml versus 5.1 ng/ml; p < 0.01). CYFRA 21-1 level after treatment showed only a low sensitivity of 32% and a specificity of 78% for tumour recurrence.

Conclusion

CYFRA 21-1 correlates with the tumour stage and, therefore, the survival of OSCC patients. Posttreatment CYFRA21-1 seems not to be a suitable predictor of tumour recurrence in the further course of the disease. However, a sudden increase of CYFRA 21-1 during follow-up may indicate a tumour recurrence in the individual patient.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043, Marburg, Germany

    Stefan A. Rudhart, Francesca Gehrt, Richard Birk, Johannes D. Schultz, Boris A. Stuck & Stephan Hoch

  2. Department of Otolaryngology, Head/Neck and Facial Plastic Surgery, Sana Kliniken Leipziger Land, Borna, Germany

    Petar Stankovic, Robert Georgiew & Thomas Wilhelm

  3. Medical Faculty, Philipps University of Marburg, Marburg, Germany

    Thomas Wilhelm

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  1. Stefan A. Rudhart
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This study does not contain any studies with human participants or animals. All procedures performed in this study were in accordance with the ethical standards of the institution or practice at which the study was conducted: Ethic commission of the Medical Faculty of the Philipps-Universität Marburg, file number: ek_mr_03_05_19_hoch-2.

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Rudhart, S.A., Gehrt, F., Birk, R. et al. Clinical relevance of CYFRA 21-1 as a tumour marker in patients with oropharyngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 277, 2561–2571 (2020). https://doi.org/10.1007/s00405-020-05962-4

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