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Jeong C, Lee J, Yoon H, Ha J, Kim MH, Bae JS, Jung CK, Kim JS, Kang MI, Lim DJ. Serum CYFRA 21.1 Level Predicts Disease Course in Thyroid Cancer with Distant Metastasis. Cancers (Basel) 2021; 13:cancers13040811. [PMID: 33671989 PMCID: PMC7919275 DOI: 10.3390/cancers13040811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 11/27/2022] Open
Abstract
Simple Summary The role of serum Cyfra 21.1 as a biomarker in thyroid cancer has yet to be validated. This study investigated the diagnostic or prognostic role of serum Cyfra 21.1 in thyroid cancer. In the present analysis, we found that serum Cyfra 21.1 was increased in thyroid cancer with distant metastasis compared with thyroid cancer without metastasis. Furthermore, in progressive disease when thyroglobulin was undetectable or thyroglobulin monitoring was useless because of thyroglobulin antibody, serial follow-up based on serum Cyfra 21.1 levels might be used as an alternative biomarker for disease monitoring. Abstract Background: Serum Cyfra 21.1, the soluble fragment of CK19, has been used as a prognostic tumor marker in various cancers, indicating poor tumor differentiation and increased metastasis. Methods: We analyzed the serum Cyfra 21.1 level in 51 consecutive patients with thyroid cancer manifesting distant metastasis treated with prior total thyroidectomy. Serum Cyfra 21.1 levels of 26 thyroid cancer patients without metastasis and 50 healthy individuals were used for comparison. Results: Higher serum Cyfra 21.1 levels were detected in thyroid cancer patients with distant metastasis compared with healthy subjects and thyroid cancer patients without metastasis (p = 0.012). Serum Cyfra 21.1 levels were significantly increased in patients with positive BRAF V600E mutation (p = 0.019), undergoing Tyrosine Kinase Inhibitor (TKI) therapy (p = 0.008), with radioiodine-refractory status (p = 0.047), and in disease progression compared with those manifesting stable disease (p = 0.007). In progressive disease with undetectable or unmonitored thyroglobulin because of thyroglobulin antibody, serum Cyfra 21.1 was useful as a biomarker for follow-up of disease course. Conclusion: Serum Cyfra 21.1 in thyroid cancer patients might represent an alternative biomarker predicting tumor progression, especially in cases not associated with serum Tg levels.
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Affiliation(s)
- Chaiho Jeong
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (C.J.); (J.H.); (M.-I.K.)
| | - Jeongmin Lee
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.L.); (M.-H.K.)
| | - Hyukjin Yoon
- Department of Nuclear Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Jeonghoon Ha
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (C.J.); (J.H.); (M.-I.K.)
| | - Min-Hee Kim
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.L.); (M.-H.K.)
| | - Ja-Seong Bae
- Department of General Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.-S.B.); (J.-S.K.)
| | - Chan-Kwon Jung
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Jeong-Soo Kim
- Department of General Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.-S.B.); (J.-S.K.)
| | - Moo-Il Kang
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (C.J.); (J.H.); (M.-I.K.)
| | - Dong-Jun Lim
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (C.J.); (J.H.); (M.-I.K.)
- Correspondence: ; Tel.: +82-2-2258-6009; Fax: +82-2-599-3589
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Giovanella L, Imperiali M, Trimboli P. Role of serum cytokeratin 19 fragment (Cyfra 21.1) as a prognostic biomarker in patients with differentiated thyroid cancer. Sci Rep 2017; 7:7359. [PMID: 28779086 PMCID: PMC5544692 DOI: 10.1038/s41598-017-07915-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 07/04/2017] [Indexed: 12/16/2022] Open
Abstract
Differentiated thyroid cancers (DTC) account for up to 85% of thyroid cancers and generally display an excellent prognosis. However, in a minority of cases, DTC progress toward less differentiated phenotypes leading to distant metastases and even disease-related deaths. Circulating biomarkers are warranted to complement the gold standard DTC marker thyroglobulin (Tg) in identifying and monitoring such cases. We measured serum Tg and Cyfra 21.1 6 to 12 months after primary treatment in 473 DTC patients. A complete response of Tg was related to an excellent outcome in all cases. Among patients with incomplete Tg response Cyfra 21.1 levels <2.07 ng/mL were associated to favorable outcome while higher levels greatly increased the risk of disease related recurrences and deaths. Both markers retained independent prognostic values in multivariate analysis. In conclusion, Cyfra 21.1 is a tool available to independently predict survival of DTC patients not achieving excellent response after primary treatment.
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Affiliation(s)
- L Giovanella
- Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and Thyroid Centre, 6500, Bellinzona, Switzerland.
| | - M Imperiali
- Ente Ospedaliero Cantonale, Department of Clinical Chemistry and Laboratory Medicine, 6500, Bellinzona, Switzerland
| | - P Trimboli
- Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and Thyroid Centre, 6500, Bellinzona, Switzerland
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Giovanella L, Treglia G, Verburg FA, Salvatori M, Ceriani L. Serum cytokeratin 19 fragments: a dedifferentiation marker in advanced thyroid cancer. Eur J Endocrinol 2012; 167:793-7. [PMID: 22989467 DOI: 10.1530/eje-12-0660] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study was undertaken to evaluate serum cytokeratin 19 fragment (Cyfra 21.1) expressions in patients with advanced thyroid carcinoma and to explore the relationship between serum Cyfra 21.1 and the degree of radioiodine ((131)I) avidity of thyroid carcinoma cells. METHODS Enrolled were 76 consecutive patients with advanced thyroid carcinoma submitted to high-activity (131)I treatment. In each patient, serum thyroglobulin (Tg) and Cyfra 21.1 were measured before (131)I administration and compared with the posttreatment whole-body scan results. RESULTS Thirty-one (41%) of 76 patients had iodine-avid and 45 (59%) had iodine-refractory diseases respectively. Significantly higher serum Cyfra 21.1, but not Tg, levels were found in patients with (131)I-refractory disease compared with patients with iodine-avid disease (P<0.01). CONCLUSIONS This is the first report describing the potential role of serum Cyfra 21.1 as marker of dedifferentiation and resistance to (131)I therapy in patients with advanced thyroid carcinoma.
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Affiliation(s)
- Luca Giovanella
- Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Via Ospedale 12, CH-6500 Bellinzona, Switzerland
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