CYFRA 21-1

Cancer

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No Fasting Required

Details

Tumor marker (fragment of cytokeratin 19).

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CYFRA 21-1 Test Information Guide

Why is it done?
- CYFRA 21-1 is a tumor marker test that measures cytokeratin 19 fragment in blood serum. It is a protein released by cancer cells, particularly epithelial cells.
- Primary use: Detection, monitoring, and prognostic assessment of non-small cell lung cancer (NSCLC), particularly squamous cell carcinoma and adenocarcinoma.
- Secondary applications: Monitoring ovarian cancer, bladder cancer, esophageal cancer, head and neck cancers, and other epithelial malignancies.
- Timing: Performed at initial diagnosis, during treatment monitoring, after completion of therapy, and during surveillance for cancer recurrence.
- Assessment of treatment response: Serial measurements help evaluate effectiveness of chemotherapy, immunotherapy, or radiation therapy.
Normal Range
- Normal/Reference Range: Less than 3.3 ng/mL (nanograms per milliliter)
- Borderline/Elevated Range: 3.3 to 6.0 ng/mL (may warrant further investigation)
- Significantly Elevated: Greater than 6.0 ng/mL (suggests possible malignancy or cancer progression)
- Units: ng/mL (nanograms per milliliter) or ng/L (nanograms per liter)
- Normal Result: Values below the cutoff suggest absence of significant epithelial cell damage or malignancy; however, normal values do not exclude cancer.
- Abnormal Result: Elevated levels suggest possible malignancy, advanced disease, or tissue damage; should be interpreted with clinical findings and imaging studies.
Interpretation
- Negative/Low Values (Less than 3.3 ng/mL):
  - Generally indicates no significant epithelial cell malignancy detected.
  - Does not completely rule out early-stage cancer or some types of malignancy.
- Moderately Elevated (3.3 to 6.0 ng/mL):
  - Warrants further investigation with imaging (CT scan, PET scan) and clinical correlation.
  - May indicate benign conditions or early malignancy.
- Significantly Elevated (Greater than 6.0 ng/mL):
  - Suggests probable malignancy or advanced cancer disease.
  - Correlates with tumor burden and may indicate poor prognosis.
- Serial Measurement Interpretation:
  - Decreasing levels: Indicates positive treatment response and disease control.
  - Increasing levels: Suggests cancer progression or treatment failure.
  - Stable levels: May indicate stable disease or need for treatment adjustment.
- Factors Affecting Results:
  - Benign lung diseases: Chronic obstructive pulmonary disease (COPD), pneumonia, pulmonary fibrosis, tuberculosis may cause mild elevation.
  - Liver disease: Hepatitis, cirrhosis may elevate levels.
  - Renal dysfunction: Impaired clearance may result in increased levels.
  - Smoking history: Current smokers may have baseline elevation.
  - Recent chemotherapy or radiation: May temporarily elevate levels due to cell damage.
Associated Organs
- Primary Organ System:
  - Respiratory system (lungs) - primary target organ, especially the airways and lung epithelium.
- Cancers Associated with Abnormal Results:
  - Non-small cell lung cancer (NSCLC): Most common association, particularly squamous cell carcinoma and adenocarcinoma.
  - Ovarian cancer: Elevated in 50-70% of advanced stage cases.
  - Bladder cancer: Elevated in majority of patients with advanced disease.
  - Esophageal cancer: Frequently elevated in advanced cases.
  - Head and neck cancers: Laryngeal and pharyngeal malignancies.
  - Gastric cancer: May be elevated in advanced stages.
  - Breast cancer: May show elevation in advanced metastatic disease.
- Benign Conditions Associated with Elevation:
  - Chronic obstructive pulmonary disease (COPD)
  - Pulmonary fibrosis
  - Tuberculosis and other chronic infections
  - Pneumonia (acute or chronic)
  - Cirrhosis and advanced liver disease
- Potential Complications of Abnormal Results:
  - Disease progression: Elevated levels correlate with advanced cancer stage and reduced survival rates.
  - Metastatic spread: High levels may indicate systemic disease or distant metastases.
  - Recurrence: Rising levels after treatment may signal cancer recurrence requiring intervention.
Follow-up Tests
- If Results are Elevated:
  - Chest CT scan: To evaluate lung parenchyma, identify nodules, or assess tumor extent.
  - PET-CT scan: To identify areas of metabolic activity and metastatic disease.
  - Chest X-ray: Initial imaging modality for lung assessment.
  - Bronchoscopy or tissue biopsy: If lung lesion identified to obtain pathological confirmation.
  - CEA (Carcinoembryonic antigen): Complementary tumor marker for lung and other cancers.
  - NSE (Neuron-specific enolase): For small cell lung cancer evaluation.
- Laboratory Tests for Differential Diagnosis:
  - Comprehensive metabolic panel: To assess liver and kidney function.
  - Complete blood count: To evaluate for anemia or blood cell abnormalities.
  - Liver function tests: If hepatic metastases or liver disease suspected.
- Monitoring During Treatment:
  - Repeat CYFRA 21-1 measurements: Every 4-12 weeks during active cancer treatment to assess response.
  - Imaging studies: Periodic CT scans (every 2-3 months) to correlate with tumor marker trends.
  - Combination marker panel: CYFRA 21-1 combined with CEA, NSE, or other markers for improved sensitivity.
- Surveillance and Follow-up Schedule:
  - Post-treatment: Every 3 months for first year, then every 6-12 months if disease-free.
  - Long-term follow-up: Annual or as clinically indicated for at least 5 years.
Fasting Required?
- Fasting Required: NO
- The CYFRA 21-1 test does not require fasting. You may eat and drink normally before the test.
- Sample Collection:
  - A simple blood draw from a vein is performed (usually from the arm).
  - Blood is collected in a sterile tube and processed in the laboratory.
  - The entire procedure takes only a few minutes.
- Special Instructions/Patient Preparation:
  - No special dietary restrictions needed before the test.
  - Wear comfortable, loose-fitting clothing that allows easy access to veins.
  - Stay well-hydrated with water before the blood draw.
  - Avoid strenuous exercise immediately before the test.
  - Inform the healthcare provider of any blood disorders or medications affecting bleeding.
- Medications:
  - No medications need to be avoided before CYFRA 21-1 testing.
  - Continue taking all prescribed medications as directed.
  - Anticoagulants (blood thinners) do not interfere with the test but inform the phlebotomist.
- Result Timeline:
  - Results typically available within 2-5 business days after blood collection.
  - Rush or stat testing may be available in certain clinical situations.

How our test process works!