The Clinical Significance Of Serum CYFRA21-1 In The Diagnosis Of Laryngeal And Hypopharyngeal Carcinoma

PrefaceKeratin is the main component of middle filaments which compose the skeleton structure of cell, keratin in human epithelial cell can be separated to 20 zones by two dimentional gel electrophoresis. They are separately named CK1 to CK20. The PH values are 5.2-7. 8 and the molecular weights are 40-68kDa. These keratins locate in the epithelial cell and have high cell and tissue specificity. Cytokeratin 19 (CK19) is expressed in simple epithelial cells and is called simple epithelial cytokeratin together with CK8 and CK18. CK19 is the keratin with the lowest molecular weight which can be first detected in squamous carcinoma cell . Recently it has been found that the soluble fragment of CK19 in the sqamous carcinoma cell can enter the blood and be detected by two kinds of monoclonal antibody KS19. 1 and BM19. 21. So it is named CYFRA21 - 1 (Cytokeratin 19 Fragment Antigen21 -1). The expression of CYFRA21 - 1 is high in the serum of patients with lung cancer. So being a new kind of tumor marker in squamous carcinoma of head and neck, CYFRA21 - 1 has attracted great attention in recent years. In this study, by comparatively analyzing the levels of serum CYFRA21 - 1 in laryngeal and hypopharyngeal carcinoma of 30 cases and normal serum, together with correlative analysis of the expression of CK19 in the samples of laryngeal and hy-popharyngeal carcinoma, we intended to study the diagnosis value of CYFRA21 - 1 in laryngeal and hypopharyngeal carcinoma.Experimental MaterialsWe acquired 30 samples of laryngeal and hypopharyngeal carcinoma from the patients hospitalizing in the ENT department of the first affiliated hospital of China Medical University from July to October in 2001. (M:24 cases F:6 cases). These patients were 38 to 81 years old, the mean age was 60. 6 11. 8 years old. he pathological results were all squamous carcinoma. Grade I:11 cases; Grade II:14 cases; Grade III:5 cases; Clinical stage; T1:8 cases; T2: 12 cases; T3: 9 cases; T4: 1 case. Lymph node metastasis; N0;19 cases; N1: 8 cases; N2: 3 cases; Clinical type: supraglottic: 14 cases; glottic: 13 cases; hypopharyngeal: 3 cases. All the patients were drawn venous blood of 2 ml after hospitalizing and the normal control samples were acquired from the healthy person when dedicating blood. The blood samples were centrifugated to obtain the serum and stored in the refrigerator under - 20℃. The fresh tumor tissue from the patients after operation was fixed in 10% formalin.Experimental methodsReagent and methods; The CYFRA21 - 1 sandwich ELISA method was applied in the venous blood samples. The Test Kit was purchased from American Mega corporation. We obtained the values of OD in 450nm , drew the standard curves and then calculated the regression equation and the concentration of samples according to the OD. The method of immunohistochemistry was two steps method. The ready-to-use CK19 antibody was purchased from American antibod-y diagnosis corporation. PBS was applied as the negative control and the lung cancer was the positive control. The images were collected through the computer image analysis system and photographed.Statistical methods: We used SPSS 10. 0 for windows to calculate the results respectively, t test was applied to calculate the difference between experimental and control group; analysis of variance and q test were applied to calculate the difference between experimental group, x2 test was applied to calculate the positivity difference between the group with lymph node metastasis and the group without. Pearson correlation and Linear regression were applied to calculate the relation between the expression of CK19 in postoperative turner samples and the preoperative level of serum CYFRA21 -1.Experimental resultsThe sensitivity, specificity and accuracy of serum CYFRA21-1 to detect laryngeal and hypopharyngeal carcinoma were respectively 50. 0% , 86. 7% and 68. 3%. The level of CYFRA21 - 1 in tumor group is 5. 16+3. 64ng/ml and in control group is 2. 43+1. 09ng/ ml, which had significant diffe...