ArticleClinical oral investigations2026
Baseline and treatment-induced change of salivary CYFRA 21 - 1 as independent predictors of recurrence in oral squamous cell carcinoma.
Article in Clinical oral investigations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesCytokeratin 19 fragment (CYFRA 21 - 1) has shown diagnostic utility in oral squamous cell carcinoma (OSCC), but its prognostic value and treatment-induced dynamics remain unclear. This study evaluated baseline and early post-treatment salivary and serum CYFRA 21 - 1 concentrations in patients with OSCC to assess associations with clinicopathological characteristics and recurrence-free survival. MATERIALS AND
methodsWe prospectively enrolled 40 patients with primary, resectable OSCC and measured salivary and serum CYFRA 21 - 1 by ELISA before surgery and 14 days post-operatively. The primary outcome was recurrence-free survival.
resultsPretreatment salivary CYFRA 21 - 1 was higher in T3-4 versus T1-2 tumors (p = 0.033) and associated with nodal metastasis (p = 0.040). Surgical resection significantly reduced CYFRA 21 - 1 levels. However, larger absolute reductions in salivary levels (≥ 0.74 ng/mL) predicted higher recurrence risk (OR = 6.09), as did elevated baseline salivary CYFRA 21 - 1 (≥ 2.66 ng/mL; OR = 9.35). Both metrics independently predicted recurrence-free survival in multivariate Cox regression (HR = 3.00-4.10), while standard clinical factors including TNM stage and nodal status did not. Salivary and serum CYFRA 21 - 1 correlated weakly to moderately (r = 0.33, p < 0.05).
conclusionsBaseline salivary CYFRA 21 - 1 and large post-treatment reductions independently predicted OSCC recurrence, outperforming TNM staging in multivariate analysis. Larger CYFRA 21 - 1 reductions were associated with increased relapse risk, potentially reflecting aggressive tumor biology, though this counterintuitive finding requires validation in larger independent cohorts before definitive mechanistic conclusions can be drawn. Monitoring CYFRA 21 - 1 kinetics may provide biologically informed prognostication beyond anatomical classification. CLINICAL RELEVANCE: Salivary CYFRA 21 - 1 offers a non-invasive biomarker for postoperative risk stratification that could guide personalized surveillance strategies, enabling early identification of high-risk patients who may benefit from intensified follow-up or adjuvant therapy.
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