Tumor marker CA 21-1 CYFRA
Why this test?
For diagnosis, assessment of prognosis and control of treatment of non-small cell lung cancer, colon adenocarcinoma and breast adenocarcinoma.
To determine the tactics of treatment of metastatic thyroid cancer.
In what cases is it prescribed?
Symptoms of lung cancer: cough, hemoptysis, shortness of breath, signs of tumor compression of surrounding structures (hoarseness of voice, difficulty swallowing), paraneoplastic syndromes (hypercalcemia, Cushingoid syndrome, Lambert-Eton syndrome).
With symptoms of colon cancer: iron deficiency anemia, rectal bleeding, abdominal pain, constipation or diarrhea.
If breast cancer is suspected.
When planning treatment tactics for metastatic thyroid cancer.
Cytokeratin 19 is one of the proteins of the cytoskeleton of epitheliocytes, which belongs to intermediate filaments (thread-like structures).
Under the influence of the enzyme caspase-3, as a result of apoptosis, cytokeratin 19 and its soluble components (C-terminus of cytokeratin 19, CYFRA 21-1, CYFRA) enter the blood, where they can be measured using laboratory methods.
An increase in the concentration of CYFRA 21-1 in blood serum is observed in some malignant neoplasms of epithelial origin: lung, colon, mammary and thyroid cancer and some others.
Detection of CYFRA 21-1 in blood serum is most typical for patients with non-small cell lung cancer and especially with one of its varieties - squamous cell lung cancer.
The CYFRA 21-1 study can be used for the differential diagnosis of small cell and non-small cell lung cancer. The concentration of CYFRA 21-1 increases in 57-59% of patients with NDRL and less often in DCRL.
The CYFRA 21-1 study has the highest sensitivity for squamous cell lung cancer. At the same time, detection of an additional tumor marker - squamous cell carcinoma antigen (SCCA) also supports the diagnosis of NDRL.
There is a direct relationship between the level of CYFRA 21-1 and the size of the tumor. In this regard, the analysis of CYFRA 21-1 is used to assess the prognosis of the NDRL. A high concentration of CYFRA 21-1 before the start of chemotherapy is an unfavorable sign.
A significant (over 27%) decrease in the concentration of CYFRA 21-1 during treatment reflects a good response to therapy. Along with the determination of tumor markers such as CA 19-9 and carcinoembryonic antigen (CARA), the CYFRA 21-1 study can be used to diagnose, evaluate the prognosis and control the treatment of colon cancer.
In colon adenocarcinoma, the level of this tumor marker is elevated, with the highest levels characteristic of large tumors. At the same time, patients with a slight increase in the concentration of CYFRA 21-1 respond better to therapy with cytostatic drugs.
The CYFRA 21-1 study can also be used to determine treatment strategies for metastatic differentiated thyroid cancer. A high concentration of this tumor marker is characteristic of aggressive thyroid cancer resistant to radioactive iodine therapy.
The most common elevated levels of CYFRA 21-1 are observed in papillary carcinoma of the thyroid gland. An increase in the concentration of CYFRA 21-1 can be detected in 65% of women with breast cancer metastases.
The sensitivity of the study of this tumor marker for breast cancer exceeds the sensitivity of PEA or CA 15-3. The combination of tests for CYFRA 21-1, REA and CA 15-3 allows for a sensitivity of about 90%. A high pre-treatment CYFRA 21-1 level is an unfavorable prognostic sign.
It must be remembered that the presence of CYFRA 21-1 does not always indicate the presence of a malignant neoplasm.
An increase in the level of this tumor marker can also be observed in various benign conditions (chronic renal failure, pulmonary fibrosis, diseases of the hepatobiliary system), so the result of the study should be evaluated taking into account additional data.