This study examines a new tumour marker,
Cyfra 21-1, as a prognostic marker in predicting the survival of H&N
cancer patients, and its correlation with clinical outcome during prolonged follow up of these patients. The study included 67 patients with primary detection of
carcinoma of H&N. The survival of these patients was evaluated in correlation with the disease stage and
Cyfra 21-1 levels at initial diagnosis. 38 patients were followed clinically and with serial assays for at least 12 months, or until recurrence was diagnosed.
Cyfra 21-1 levels were determined periodically, using an Elisa kit. Patients with
Cyfra 21-1 < 1.5 ng ml(-1)had a higher survival rate compared to patients with
Cyfra 21-1 > or = 1.5 ng ml(-1)(63% vs. 20%, respectively). The risk ratio of Ln(Cyfra 21-1) is 1.62 (P = 0.028). In a Cox regression model that included the disease stage and Ln(Cyfra 21-1), Ln(Cyfra 21-1) was preferred as the main parameter for predicting patients survival. In 83% of the 12 patients with recurrent or residual disease,
Cyfra 21-1 was elevated before or during clinical detection of the recurrence.
Cyfra 21-1 was found to be a prognostic marker for
carcinoma of H&N, unrelated to the stage of the disease. Elevated levels of
Cyfra 21-1 without clinical evidence of disease can be attributed to the marker's mean lead-time as compared to the clinical appearance of the disease.