Indian Journal of Nuclear Medicine
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Year : 2020  |  Volume : 35  |  Issue : 2  |  Page : 116-121

Evaluation of CYFRA 21.1 as a dedifferentiation marker of advanced thyroid cancer

1 Nuclear Medicine Division, Department of Radiotherapy, Kasturba Medical College, Manipal, Karnataka, India
2 Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
3 Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Dr. Chandrashekhar Bal
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijnm.IJNM_148_19

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Purpose of the Study: Well-differentiated thyroid carcinomas have good prognosis, but as it de-differentiates, the survival rates go down. Early identification of such patients needs a marker which indicates the dedifferentiation process. CYFRA 21.1 has also shown to be increased in patients with131I refractory thyroid cancer. We tested whether CYFRA 21.1 can differentiate between131I avid and refractory tumors. Methodology: Well-differentiated thyroid cancer patients with known distant metastases were accrued and tested for stimulated and unstimulated thyroglobulin and CYFRA 21.1. All patients underwent131I whole-body scan,131I post therapy scan, and18F-Fluorodeoxyglucose positron emission tomography-computed tomography. Those with even a single131I nonavid lesion were considered131I refractory disease. CYFRA 21.1 of both131I avid and nonavid was compared, and CYFRA 21.1 levels against disease extent were analyzed. Results: CYFRA 21.1 levels were significantly elevated in131I refractory group. A cutoff value of 2.07 ng/ml distinguished between131I avid and refractory disease with high sensitivity and specificity (88% and 89. 7%, respectively). However, CYFRA 21.1 levels were similar in patients when analyzed based on disease sites. Conclusion: CYFRA 21.1 can be utilized to differentiate between131I avid and refractory diseases. Further long-term studies are required to use it as a predictive and prognostic marker.

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