Diagnostic accuracy and prognostic applications of CYFRA 21-1 in head and neck cancer: A systematic review and meta-analysis

Cytokeratin fraction 21-1 (CYFRA 21-1) has been widely studied as an important biomarker in non-small cell lung cancer for both diagnosis and prognosis. Many studies have also assessed the clinical applications of CYFRA 21-1 in head and neck cancer, but the diagnostic and prognostic values of CYFRA 21-1 are not yet fully established. This pooled analysis aims at evaluating the diagnostic accuracy and prognostic applications of CYFRA 21-1 in patients with head and neck cancer. A systematic retrieval of literatures was conducted without time or language restrictions by searching PubMed, EMBASE, Web of Science, Cochrane library and China National Knowledge Infrastructure. Twenty studies were eligible for systematic review, of which 14 conformed for diagnostic analysis and 7 for prognostic analysis. The pooled sensitivity and specificity of CYFRA 21-1 analysis were 0.53 (95% CI: 0.39-0.67) and 0.97 (95% CI: 0.93-0.99), respectively. A high level of CYFRA 21-1 was significantly correlated with shorter overall survival (HR 1.33, 95% CI: 1.13-1.56) and disease-free survival (HR 1.48; 95%CI: 1.10-1.97). Current evidence indicates that the level of CYFRA 21-1 in the serum could be used as an indicator for monitoring tumor status and evaluating its curative effects.