Article Abstract

Head-to-head comparison of serum and urine cytokeratin-19 fragments (CYFRA 21–1) for bladder cancer diagnosis

Authors: Fengwen Fu, Fanchun Zeng, Zhongyi Sun, Fengshuo Jin

Abstract

Background: Some studies have investigated the diagnostic accuracy of cytokeratin-19 fragments (CYFRA 21-1) for bladder cancer, but no study has compared the diagnostic accuracy of serum and urine CYFRA 21-1 in a head-to-head manner. The aims of this study were to (I) compare the diagnostic accuracy of serum and urine CYFRA 21-1 and (II) investigate whether the diagnostic accuracy can be improved if serum and urine CYFRA 21-1 were used together.
Methods: In this prospective study, we enrolled patients with bladder cancer symptoms that were admitted to our hospital between January 1, 2016, and December 31, 2016. Serum and urine CYFRA 21-1 were detected using a Maglumi 2000 Plus immunoassay analyser. The diagnostic accuracy of the serum and urine CYFRA 21-1 was assessed using a receiver operating characteristic (ROC) curve analysis and multivariable logistic regression.
Results: A total of 234 subjects were enrolled in the study, 152 with bladder cancer and 82 with nonbladder cancer. The areas under the ROC curve (AUCs) for serum and urine CYFRA 21-1 were comparable (0.74 vs. 0.74, P=0.91). The AUC for the serum and urine CYFRA 21-1 combination was 0.83, which was significantly higher than that of the serum (P=0.04) and urine (P=0.03) CYFRA 21-1 alone.
Conclusions: Both the serum and urine CYFRA 21-1 have comparable diagnostic accuracy for bladder cancer. The diagnostic accuracy can be improved if the serum and urine CYFRA 21-1 are used together.