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

Shirong Li; Wene Wei; Zhaorong Feng; Yingzhen Bian; Jinmiao Pan; Jinling Mai; Shufang Ning; Jinglei Huang; Xiangyang Gao; Litu Zhang

doi:10.2147/CMAR.S410477

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

Cancer Manag Res. 2023 Jul 6:15:601-614. doi: 10.2147/CMAR.S410477. eCollection 2023.

Authors

Shirong Li^#¹, Wene Wei^#¹, Zhaorong Feng^#¹, Yingzhen Bian¹, Jinmiao Pan¹, Jinling Mai¹, Shufang Ning^{1

2}, Jinglei Huang¹, Xiangyang Gao^#³, Litu Zhang^#^{1

2}

Affiliations

¹ Department of Research, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China.
² Department of Research, Guangxi Cancer Molecular Medicine Engineering Research Center, Nanning, People's Republic of China.
³ Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: 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: CRLM; CYFRA21-1; colorectal cancer; colorectal liver metastases; cytokeratin-19 fragments; overall survival; prognosis; progression-free survival.

Grants and funding

This study was supported by grants from the Key R&D Program of Scientific Research and Technology Development Project of Guangxi (Grant No. 2022AB11046), the Key R&D Program of Scientific Research and Technical Development Project of Qingxiu District, Nanning, Guangxi (Grant No. 2021015), the Key R&D Program of Scientific Research and Technology Development Project of Nanning, Guangxi (Grant No. ZC20213009) and the Technology Development Program Project, and the Self-funded scientific research project of Guangxi Zhuang Autonomous Region Health Committee (Grant No. 20191022), Guangxi Medical and health key discipline construction project.