Urine CYFRA 21-1 in the diagnostics of bladder cancer patients

Cystoscopy and cytology are the standard modalities used to diagnose and early detect persistent or recurrent bladder cancer. One of the possibilities of improvement in the diagnosis of bladder cancer was the introduction of assessment of tumor markers, especially evaluated in urine. The results of the recent studies on CYFRA 21-1, soluble cytokeratin 19 fragments, indicated that it is one of the promising tumor markers for bladder cancer. Serum CYFRA 21-1 was significantly higher in the bladder cancer group than in patients with benign bladder disease or healthy controls. However, opinions about the usefulness of results of CYFRA 21-1 in serum for diagnosis and follow-up of bladder cancer differ. Some authors have emphasized the utility of urine markers in considering detection and surveillance of bladder cancer. Sensitivity of CYFRA 21-1 ranged between 43% and 96.9% and specificity between 41% and 67.2%, in various studies, with different selection of the cut-off point. No significant differences were observed between urine CYFRA 21-1 levels in bladder cancer group and patients with benign bladder disease or treated with radiotherapy and intravesical instiallations. Sensitivity was grater for invasive than for superficial bladder cancer. Urine CYFRA 21-1 concentrations are significantly higher in respect of stage of disease, tumour size and tumour grade. Sensitivities for multiple tumors were higher for CYFRA 21-1. CYFRA 211, with its sensitivity over 60%, which is superior to the average values described for cytology, could be included, along with cytology, in routine examinations for clinical monitoring of patients with bladder cancer.