Clinical utility of cytokeratins as tumor markers

Cytokeratins, belonging to the intermediate filament (IF) protein family, are particularly useful tools in oncology diagnostics. At present, more than 20 different cytokeratins have been identified, of which cytokeratins 8, 18, and 19 are the most abundant in simple epithelial cells. Upon release fr...

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Bibliographic Details
Published in:Clinical Biochemistry 2004-07, Vol.37 (7), p.529-540
Main Authors: Barak, Vivian, Goike, Helena, Panaretakis, Katja W., Einarsson, Roland
Format: Article
Language:English
Subjects:
Antigens, Neoplasm - blood
Biomarkers, Tumor - blood
Biomarkers, Tumor - economics
Cancer
CYFRA 21-1
Cytokeratins
Female
Humans
Keratin-19
Keratins - blood
Male
Monitoring
Neoplasm Metastasis
Neoplasms - blood
Neoplasms - diagnosis
Peptides - blood
Predictive Value of Tests
Prognosis
Tissue Polypeptide Antigen - blood
TPA
TPS
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Summary:Cytokeratins, belonging to the intermediate filament (IF) protein family, are particularly useful tools in oncology diagnostics. At present, more than 20 different cytokeratins have been identified, of which cytokeratins 8, 18, and 19 are the most abundant in simple epithelial cells. Upon release from proliferating or apoptotic cells, cytokeratins provide useful markers for epithelial malignancies, distinctly reflecting ongoing cell activity. It appears that motifs in certain cytokeratins make them likely substrates for caspase degradation, and their subsequent release occurs during the intermediate events in apoptosis. The clinical value of determining soluble cytokeratin protein fragments in body fluids lies in the early detection of recurrence and the fast assessment of the efficacy of therapy response in epithelial cell carcinomas. The three most applied cytokeratin markers used in the clinic are tissue polypeptide antigen (TPA), tissue polypeptide specific antigen (TPS), and CYFRA 21-1. TPA is a broad spectrum test that measures cytokeratins 8, 18, and 19. TPS and CYFRA 21-1 assays are more specific and measure cytokeratin 18 and cytokeratin 19, respectively. By following patients with repeated testing during management, the oncologist may obtain critical information regarding the growth activity in symptomatic patients. Although their main use is to monitor treatment and evaluate response to therapy, early prognostic information particularly on tumor progression and metastasis formation is also provided for several types of cancers. Cytokeratin tumor markers can accurately predict disease status before conventional methods and offer a simple, noninvasive, cheap, and reliable tool for more efficient management.
ISSN:0009-9120
1873-2933
DOI:10.1016/j.clinbiochem.2004.05.009