Iranian Journal of Colorectal Research

Iranian Journal of Colorectal Research

Cytokeratin Fragment 21.1 is a Useful Tumor Marker in Colonic Adenocarcinoma: A Cross-sectional Study

Document Type : Research/Original Article

Authors
Meer M Chisthi 1
Krishnakumar G Kuttanchettiyar 2
Viswanathan V Kollengode 1
1 Department of General Surgery, Government Medical College, Trivandrum, Kerala, India
2 Department of General Surgery, Government Medical College, Konni, Kerala, India
10.30476/acrr.2022.97044.1157
Abstract
Background: Colorectal carcinoma is rising worldwide, representing a major cause of cancer-related mortality and morbidity. Carcinoembryonic antigen (CEA) is an established tumor marker for colorectal cancer, with uses in screening, pre-treatment staging, post-therapeutic monitoring, and recurrence detection. However, multiple factors affect CEA, including smoking and benign gastrointestinal diseases. Hence, there is a need to investigate alternative tumor markers like cytokeratin fragment 21.1 (CYFRA 21.1).
Methods: This study aimed to determine if the combination of CYFRA 21.1 and CEA is superior to CEA alone as a diagnostic marker in colonic cancer. In this cross-sectional study from June 2016 to December 2019, 69 consecutive patients with a histologically-confirmed diagnosis of colonic adenocarcinoma were studied. The serum levels of both tumor markers were analyzed before starting any definite treatment. The sensitivity and positive predictive values for both tumor markers were calculated. The correlation between tumor markers was tested using Pearson’s correlation. The correlation between the TNM stage and tumor markers was tested using Spearman’s Rho test.
Results: Forty-one patients had elevated CEA, while 33 patients had elevated CYFRA 21.1. CEA and CYFRA 21.1 mildly positively correlated with each other, with an R-value of 0.2598 (P=0.031). Spearman’s correlation with the clinical stage of cancer was found to be 0.50834 for CEA (P<0.005) and 0.59828 for CYFRA 21.1 (P<0.005). The sensitivity of CEA was 59.42%, while that of CYFRA 21.1 was 47.83%. The combination of both had a sensitivity of 75.36%.
Conclusion: The combination of CYFRA 21.1 and CEA was more effective in picking up cases of colonic cancer than CEA alone. Both CYFRA 21.1 and CEA correlated well with the stage of the disease. Combining these biomarkers might has great potential to evolve as a diagnostic aid in colonic cancer. 
Keywords
Adenocarcinoma
Colon cancer
Tumor markers
Carcinoembryonic antigen
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Iranian Journal of Colorectal Research
Volume 10, Issue 4
Autumn 2022
Pages 143-149