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

Document Type : Research/Original Article


1 Department of General Surgery, Government Medical College, Trivandrum, Kerala, India.

2 Department of General Surgery, Government Medical College, Konni, Kerala, India.


Background: Colorectal carcinoma forms a major cause of cancer-related mortality and morbidity, while having increasing incidence, all over the world. Carcino Embryonic Antigen(CEA) is the established tumour marker for colorectal cancer, with uses in screening, pre treatment staging, post therapeutic monitoring and detecting recurrence. However, CEA is affected by multiple factors including smoking or benign gastrointestinal diseases. Hence the need for investigating alternative tumour markers like Cytokeratin fragment 21-1(CYFRA 21-1).
Materials and Methods: The objective of this Cross Sectional study were to find if the combination of CYFRA 21-1 and CEA is superior to CEA alone as a diagnostic marker in colonic cancer. From June 2016 to December 2019, 69 consecutive patients with a histologically confirmed diagnosis of colonic adenocarcinoma were included in the study. The serum levels of both tumour markers were analysed before starting any definite treatment. Sensitivity and Positive Predictive Values for both tumour markers were calculated. Correlation between tumour markers was tested using Pearson’s correlation. Correlation between TNM stage and tumour marker was tested using Spearman’s Rho test.
Results: 41 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 value 0.031). Spearman’s correlation with clinical stage of cancer was found to be 0.50834 for CEA(p value < 0.005) and 0.59828 for CYFRA 21-1(p value < 0.005). Sensitivity of CEA 59.42%, while that of CYFRA 21-1 was 47.83%. The combination of both had a sensitivity of 75%.
Conclusion:. The combination of CYFRA 21-1 and CEA was found to be more effective in picking up cases of colonic cancer than CEA alone. Both CYFRA 21-1 and CEA correlated well with the stage of disease. A combination of these biomarkers has great potential to evolve as diagnostic aid in colonic cancer.


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