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Serum cytokeratin 19 fragment (CYFRA21-1) as a prognostic factor in intrahepatic cholangiocarcinoma.
Ann Surg Oncol. 2008 Feb; 15(2):583-9.AS

Abstract

BACKGROUND

A high serum cytokeratin 19 fragment (CYFRA21-1) concentration in patients with various cancers is associated with poor prognosis. This study aimed to establish the clinical significance of preoperative serum CYFRA21-1 in patients with intrahepatic cholangiocarcinoma.

METHODS

CYFRA21-1, carcinoembryonic antigen (CEA), and carbohydrate antigen (CA) 19-9 concentrations were measured in sera from 71 patients with intrahepatic cholangiocarcinoma. The prognostic significance of serum CYFRA21-1 levels was assessed by univariate and multivariate analyses.

RESULTS

Analysis of the areas under the receiver operator characteristic (ROC) curves clearly showed better discrimination between intrahepatic cholangiocarcinoma and benign liver diseases for CYFRA 21-1 than for CEA or CA 19-9. Based on the maximization of the Youden's index, the optimal cut-off value was 2.7 ng ml(-1) for CYFRA 21-1 (sensitivity, 74.7%; specificity, 92.2%). The serum CYFRA21-1 concentration was related to tumor stage, since the CYFRA21-1 concentrations varied according to tumor size, vascular invasion, and number of tumors. The 3-year recurrence-free survival rates for patients with high and low concentrations of CYFRA21-1 were 25.0% and 76.2%, respectively (log-rank test, p < 0.01). The 3-year overall survival rates for patients with high and low concentrations of CYFRA21-1 were 39.4% and 63.6%, respectively (p = 0.01). On multivariate analysis, a high concentration of CYFRA21-1, nodal metastases, and a microscopic resection margin involvement were independent prognostic factors associated with both tumor recurrence and postoperative death.

CONCLUSIONS

A high serum CYFRA21-1 concentration is associated with tumor progression and poor postoperative outcomes in patients with intrahepatic cholangiocarcinoma.

Authors+Show Affiliations

Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. m6877710@msic.med.osaka-cu.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17955299

Citation

Uenishi, Takahiro, et al. "Serum Cytokeratin 19 Fragment (CYFRA21-1) as a Prognostic Factor in Intrahepatic Cholangiocarcinoma." Annals of Surgical Oncology, vol. 15, no. 2, 2008, pp. 583-9.
Uenishi T, Yamazaki O, Tanaka H, et al. Serum cytokeratin 19 fragment (CYFRA21-1) as a prognostic factor in intrahepatic cholangiocarcinoma. Ann Surg Oncol. 2008;15(2):583-9.
Uenishi, T., Yamazaki, O., Tanaka, H., Takemura, S., Yamamoto, T., Tanaka, S., Nishiguchi, S., & Kubo, S. (2008). Serum cytokeratin 19 fragment (CYFRA21-1) as a prognostic factor in intrahepatic cholangiocarcinoma. Annals of Surgical Oncology, 15(2), 583-9.
Uenishi T, et al. Serum Cytokeratin 19 Fragment (CYFRA21-1) as a Prognostic Factor in Intrahepatic Cholangiocarcinoma. Ann Surg Oncol. 2008;15(2):583-9. PubMed PMID: 17955299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum cytokeratin 19 fragment (CYFRA21-1) as a prognostic factor in intrahepatic cholangiocarcinoma. AU - Uenishi,Takahiro, AU - Yamazaki,Osamu, AU - Tanaka,Hiromu, AU - Takemura,Shigekazu, AU - Yamamoto,Takatsugu, AU - Tanaka,Shogo, AU - Nishiguchi,Shuhei, AU - Kubo,Shoji, Y1 - 2007/10/23/ PY - 2007/06/13/received PY - 2007/09/17/accepted PY - 2007/09/13/revised PY - 2007/10/24/pubmed PY - 2008/3/14/medline PY - 2007/10/24/entrez SP - 583 EP - 9 JF - Annals of surgical oncology JO - Ann Surg Oncol VL - 15 IS - 2 N2 - BACKGROUND: A high serum cytokeratin 19 fragment (CYFRA21-1) concentration in patients with various cancers is associated with poor prognosis. This study aimed to establish the clinical significance of preoperative serum CYFRA21-1 in patients with intrahepatic cholangiocarcinoma. METHODS: CYFRA21-1, carcinoembryonic antigen (CEA), and carbohydrate antigen (CA) 19-9 concentrations were measured in sera from 71 patients with intrahepatic cholangiocarcinoma. The prognostic significance of serum CYFRA21-1 levels was assessed by univariate and multivariate analyses. RESULTS: Analysis of the areas under the receiver operator characteristic (ROC) curves clearly showed better discrimination between intrahepatic cholangiocarcinoma and benign liver diseases for CYFRA 21-1 than for CEA or CA 19-9. Based on the maximization of the Youden's index, the optimal cut-off value was 2.7 ng ml(-1) for CYFRA 21-1 (sensitivity, 74.7%; specificity, 92.2%). The serum CYFRA21-1 concentration was related to tumor stage, since the CYFRA21-1 concentrations varied according to tumor size, vascular invasion, and number of tumors. The 3-year recurrence-free survival rates for patients with high and low concentrations of CYFRA21-1 were 25.0% and 76.2%, respectively (log-rank test, p < 0.01). The 3-year overall survival rates for patients with high and low concentrations of CYFRA21-1 were 39.4% and 63.6%, respectively (p = 0.01). On multivariate analysis, a high concentration of CYFRA21-1, nodal metastases, and a microscopic resection margin involvement were independent prognostic factors associated with both tumor recurrence and postoperative death. CONCLUSIONS: A high serum CYFRA21-1 concentration is associated with tumor progression and poor postoperative outcomes in patients with intrahepatic cholangiocarcinoma. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/17955299/Serum_cytokeratin_19_fragment__CYFRA21_1__as_a_prognostic_factor_in_intrahepatic_cholangiocarcinoma_ L2 - https://dx.doi.org/10.1245/s10434-007-9650-y DB - PRIME DP - Unbound Medicine ER -