Abstract
BACKGROUND: Laryngeal squamous cell carcinoma (LSC) is the leading malignant tumour of the head and neck. Establishing new biomarkers is extremely important because they can be important for early diagnosis and prognosis of LSC. OBJECTIVE: The aim of this study was to establish the significance of cytokeratin fragment antigen 21-1 (CYFRA 21-1) in the early diagnosis and prognosis of LSC. METHODS: This was prospective research involving 35 patients of both sexes with pathohistologically confirmed LSC, who were treated in the period from 2022 to 2024. The control group consisted of 30 patients who underwent surgery for other non-malignant diseases and who had a normal indirect laryngoscopy findings. The levels of CYFRA 21-1 were determined for three time periods: preoperative, four weeks after surgery, and three months after radiotherapy or concomitant chemoradiotherapy. For the statistical analysis of data we used descriptive statistics methods, the Student T-test and the χ2 test to calculate the significance of the tested differences, where differences on the level of p<0.05 were considered to be statistically significant. RESULTS: Statistically significantly higher mean serum levels of CYFRA 21-1 were found preoperatively in the experimental group in comparison with the control group (p<0.001). Statistically significant lower levels of CYFRA 21-1 were found four weeks after surgery in the experimental group in comparison with preoperative levels (p=0.004). A statistically significant decrease in serum levels of CYFRA 21-1 was also found three months after radiotherapy or concomitant chemoradiotherapy in comparison with the preoperative levels (p=0.001). The serum levels of CYFRA 21-1 were statistically significantly higher preoperatively in patients with stage III/IV of the disease in comparison with stage I/II (p<0.001). CONCLUSION: Increased levels of CYFRA 21-1 are a significant indication of the presence of LSC, especially in patients with advanced stages of the disease.