Cancer Management and Research (Jul 2023)

Role of Serum CYFRA 21-1 in Diagnosis and Prognostic in Colorectal Liver Metastases

  • Li S,
  • Wei W,
  • Feng Z,
  • Bian Y,
  • Pan J,
  • Mai J,
  • Ning S,
  • Huang J,
  • Gao X,
  • Zhang L

Journal volume & issue
Vol. Volume 15
pp. 601 – 614

Abstract

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Shirong Li,1,* Wene Wei,1,* Zhaorong Feng,1,* Yingzhen Bian,1 Jinmiao Pan,1 Jinling Mai,1 Shufang Ning,1,2 Jinglei Huang,1 Xiangyang Gao,3,* Litu Zhang1,2,* 1Department of Research, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 2Department of Research, Guangxi Cancer Molecular Medicine Engineering Research Center, Nanning, People’s Republic of China; 3Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiangyang Gao; Litu Zhang, Email [email protected]; [email protected]: In current studies, the role of serum Cytokeratin-19 fragments (CYFRA 21-1) in colorectal cancer (CRC) remains unclear. This study aimed to clarify the diagnostic and prognostic value of CYFRA 21-1 in CRC.Patients and Methods: Data were collected for 196 stage I–III CRC patients and 50 colorectal liver metastases (CRLM) patients between January 2018 and December 2019. The serum CYFRA 21-1 levels were measured using the chemiluminescent particle immunoassay (CMIA) kit in all objects and common biomarkers such as CA19-9, CEA, HSP90α, and AFP were measured in all colorectal cancer patients. We investigated the association between CYFRA 21-1 level and clinicopathological features. In addition, we evaluated the ability of serum CRFRA21-1 to differentiate CRLM from CRC. To assess the potential prognostic value, we used Cox proportional hazard model for univariate or multivariate analyses.Results: Serum CYFRA 21-1 was significantly elevated in CRLM patients compared to stage I–III CRC patients (5.85 ng/mL vs 2.29 ng/mL, p < 0.001). For all CRC patients cohort, stage I–III CRC patients cohort and CRLM patients cohort, the optimal cutoff levels of CYFRA 21-1 for overall survival (OS) were 3.47 ng/mL, 2.14 ng/mL and 7.63 ng/mL, respectively, and the optimal cutoff levels for progression-free survival (PFS) were 3.47 ng/mL, 2.56 ng/mL and 7.63 ng/mL, respectively. For CRLM patients, Kaplan–Meier analysis showed that patients with high CYFRA 21-1 level had poor OS. Multivariate analysis indicated that the CYFRA 21-1 level was an independent prognostic factor for PFS in stage I–III patients. And CYFRA 21-1 levels and age were independent prognostic factors for OS and PFS in CRLM patients.Conclusion: CYFRA 21-1 can better differentiate CRLM patients from the whole CRC patients and has unique prognostic value for CRLM patients.Keywords: colorectal cancer, colorectal liver metastases, CRLM, prognosis, cytokeratin-19 fragments, CYFRA21-1, overall survival, progression-free survival

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