Clinical significance of combined examination of pretreatment serum CYFRA21-1 and SCCAg in cervical cancer patients

Abstract

Background and objective: Cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) can be used for the quantitative examination of fragment of cytokeratin 19, and is a valuable tumor marker in various malignancies. This study was to investigate the significance of pretreatment serum CYFRA21-1 and squamous cell carcinoma antigen (SCCAg) in diagnosis and their correlations to the clinicopathologic features of cervical carcinoma.

Methods: One hundred cervical carcinoma patients underwent pretreatment serum CYFRA21-1 and SCCAg evaluation; 20 healthy women were subjected as control. The specificity and sensitivity of CYFRA21-1 and SCCAg as diagnostic indexes were analyzed; their correlations to clinicopathologic features were investigated through univariate and multivariate analyses.

Results: The specificity of CYFRA21-1 and SCCAg in diagnosing cervical cancer were both 100%. The sensitivity of CYFRA21-1 and SCCAg in diagnosing cervical cancer were 36.0% and 47.0% respectively, without significant difference. The combined examination of CYFRA21-1 and SCCAg elevated the sensitivity to 60.0%, which was significantly higher than that of examining CYFRA21-1 alone. Univariate analysis showed elevation of CYFRA21-1 was related with FIGO stage and tumor size; elevation of SCCAg was related with pathologic type, tumor size, deep stromal invasion and pelvic node metastasis. Multivariate analysis showed that elevation of CYFRA21-1 had no relationship with any factors, while elevation of SCCAg was related with deep stromal invasion and pelvic node metastasis. The sensitivity of SCCAg in predicting pelvic node metastasis and deep stromal invasion were significantly higher than those of CYFRA21-1 (75.0% vs. 29.2%, p = 0.001; 55.8% vs. 26.9%, p = 0.024), and the addition of CYFRA21-1 to SCCAg could not significantly improve the sensitivity compared with SCCAg alone (79.2% vs. 75.0%, p > 0.05; 63.5% vs. 55.8%, p > 0.05).

Conclusion: The value of pretreatment serum CYFRA21-1 as predictor of pelvic node metastasis and deep stromal invasion is less significant compared with that of SCCAg. For cervical squamous cell cancer, SCCAg is the preferred tumor marker.