Cytokeratin Serum Biomarkers in Patients with Colorectal Cancer

Anticancer Research, 05/17/2012

Holdenrieder S et al. – Cytokeratins are elevated in patients with colorectal cancer (CRC) and show some association with response to primary therapy and prognosis.


  • Pretherapeutic levels of cytokeratin-19 fragments (CYFRA 21-1), carcino-embryonic antigen (CEA) and cancer antigen (CA) 19-9 were measured in 42 patients with CRC, 45 with benign colorectal diseases and 51 healthy controls.
  • Furthermore, courses of CYFRA 21-1, tissue polypeptide antigen (TPA), tissue polypeptide specific antigen (TPS), M30-antigen, CEA and CA 19-9 were analyzed in prospectively collected sera of 15 patients with CRC during primary chemotherapy and were correlated with therapy response and overall survival (OS).


  • Similar to CEA and CA 19-9, CYFRA 21-1 was significantly elevated in serum from patients with CRC (median 2.1ng/ml) as compared with healthy (1.2ng/ml; p<0.0001) and benign gastrointestinal controls (1.7ng/ml; p=0.0178) and showed stage dependency in CRC (p=0.0118).
  • CYFRA 21-1 correlated with CEA in benign diseases and CRC but not with CA 19-9.
  • The best discrimination between healthy controls and patients with CRC was achieved by combination of CYFRA 21-1 and CA 19-9 (area under the curve; AUC=86.7%), while the combination of CEA and CA 19-9 discriminated best between benign diseases and CRC (AUC=73.9%).
  • In CRC patients during primary chemotherapy, levels of cytokeratins CYFRA 21-1, TPA, TPS, CEA and CA 19-9 tended to be higher in patients with poor response to therapy and with poor prognosis.

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