Cyfra 21-1 in monitoring cervical cancer: a comparison with tissue polypeptide antigen and squamous cell carcinoma antigen.

Cyfra 21-1, measuring serum fragments of cytokeratin 19, has been found to be related to tumour stage and tumour size in patients with cervical cancer and suggested to be a promising marker in squamous cell lung cancer. We compared the value of this new marker with tissue polypeptide antigen (TPA) and squamous cell carcinoma antigen (SCC-Ag) in monitoring 30 patients with squamous cell cervical cancer. Serum levels of each marker were studied in relation to tumour stage and clinical status of the patient. The clinical performance of the various assays to separate those patients with complete remission from those patients with the presence of tumour (i.e., partial remission, stable disease, or progressive disease) was assessed by their receiver operating characteristic (ROC) curves. We found that tumour stage was a prognostic factor for survival (p=0.02). Pretreatment serum Cyfra 21-1, TPA, and SCC-Ag levels were not related to stage of disease and were not found to be predictive of survival. In contrast, an elevated post-treatment serum SCC-Ag level was associated with a poor survival rate (p=0.03). Such a relation was not found for Cyfra 21-1 or TPA. The clinical performance of post-treatment serum SCC-Ag levels in predicting the presence of tumour was better than the Cyfra 21-1 or TPA assays. This is shown by the left uppermost position of the ROC curve for SCC-Ag. We concluded that SCC-Ag appeared to be a better parameter than Cyfra 21-1 and TPA in predicting the presence of tumour during follow-up and survival of patients with cervical cancer.