Details

Autor(en) / Beteiligte

• Chapman, Michael H, PhD MRCP
• Sandanayake, Neomal S, FRACP
• Andreola, Fausto, PhD
• Dhar, Dipok K, MBBS
• Webster, George J, MD FRCP
• Dooley, James S, MD FRCP
• Pereira, Stephen P, PhD FRCP

Titel

Circulating CYFRA 21-1 is a Specific Diagnostic and Prognostic Biomarker in Biliary Tract Cancer

Ist Teil von

• Journal of clinical and experimental hepatology, 2011-06, Vol.1 (1), p.6-12

Ort / Verlag

India: Elsevier B.V

Erscheinungsjahr

2011

Link zum Volltext

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• Abstract Background Biliary tract cancer (BTC) has a poor prognosis, in part related to difficulties in diagnosis. Cytokeratin 19 (CK19) is a constituent of the intermediate filament proteins of epithelial cells. CK19 fragments (CYFRA 21-1) are rarely identified in the blood of healthy individuals. We assessed the utility of CYFRA 21-1 as a diagnostic and prognostic marker of BTC. Methods Blood was prospectively collected from patients with benign biliary disease (n = 39), primary sclerosing cholangitis (n = 19), PSC-related cholangiocarcinoma (n = 6) and sporadic BTC (n = 60). CYFRA 21-1 levels were measured in duplicate by ELISA. Results CYFRA 21-1 (≤1.5 ng/mL) had a sensitivity of 56% and specificity of 88%, compared with figures of 79% and 78% for CA 19-9 (≤37 U/mL). Using a higher cut-off of 3 ng/mL, CYFRA 21-1 had a sensitivity of 30% and specificity of 97%. Combination of CYFRA 21-1 (≤1.5 ng/mL) and CA 19-9 (≤37 U/mL) resulted in sensitivity and specificity of 45% and 96%. In contrast to CA 19-9, CYFRA 21-1 (≤3.0 ng/mL) alone was a strong predictor of prognosis (median survival 2 months vs 10 months, p = 0.001). Conclusion Elevated circulating CYFRA 21-1 is a specific, but less sensitive diagnostic marker than CA 19-9, predicts a poor outcome and may act as a surrogate marker of circulating tumor cells in BTC. Further prospective studies of its utility in assessing operability and response to chemotherapy are needed.