الفهرس 
INTRODUCTION and Aim of the workOnly 14 pages are availabe for public view
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Abstract
It has been reported that the cytokeratin 19 (CK 19) fragment, CYFRA 21-1, is increased in the sera of patients with hepatocellular carcinoma (HCC). Other studies stated that serum CYFRA 21-1 is not elevated in patients with HCC, as normal hepatocytes do not produce CK 19, but elevated only in patients with intrahepatic cholangiocarcinoma (ICC). Thus, it is important for differentiation between HCC and ICC. This study was done to evaluate the importance of CYFRA 21-1 measurement in patients with primary liver cancer and in patients with chronic liver diseases. Using an electrochemiluminescent immunoassay, serum CYFRA 21-1 concentrations were measured in sera from 34 patients with primary hepatic malignancy (14 patients with hepatocellular carcinoma and 20 patients with cholangiocarcinoma), 17 patients with liver cirrhosis, 18 patients with chronic viral hepatitis and 18 apparently healthy volunteers. Concentrations of serum CYFRA 21-1 were significantly higher in patients with primary liver malignancy group (meanSEM=9.781.86 ng/ml); (Mann-Whitney U-test P< 0.001), hepatocellular carcinoma group (meanSEM=3.670.45ng/ml); (Mann-Whitney U-test P< 0.001) and cholangiocarcinoma group (meanSEM=14.062.79 ng/ml); (Mann-Whitney U-test P< 0.001) when compared with control group (meanSEM=1.250.1 ng/ml). There was a significant increase in CYFRA 21-1 level in cholangiocarcinoma group when compared with hepatocellular carcinoma group (Mann-Whitney U-test P=0.02). CYFRA 21-1 shows highly significant increase in viral hepatitis group (meanSEM= 2.650.29 ng/ml); (Mann-Whitney U-test P<0.001) and liver cirrhosis group(meanSEM=3.330.51 ng/ml); (Mann-Whitney U-test P<0.001 ) when compared with control group. Using cut-off value of serum CYFRA 21-1 (4 ng/ml), double the maximum value in control group which was (1.98 ng/ml), the diagnostic value of CYFRA 21-1 was (11.1% in diagnosing viral hepatitis, 29.4% in diagnosing liver cirrhosis, 21.4% in diagnosing HCC and 60% in diagnosing CC). From this study it is concluded that CYFRA 21-1 can be used as a marker in the diagnosis of primary hepatic malignancy and that CYFRA 21-1 together with AFP are useful marker for differentiation between ICC and HCC. Serum levels of CYFRA 21-1 increase in some patient with benign liver diseases. Those cases with elevated levels are recommended to be followed up for malignant transformation, as elevated CYFRA 21-1 levels in those cases may be indicator for the possibility of malignant transformation in the future.