Makrantonakis P, Pectasides D, Aggouridakis C, Visvikis A, Daniilidis J, Fountzilas G
Ahepa Hospital, Aristotele University of Thessaloniki, Greece.
Am J Clin Oncol. 1999 Dec;22(6):542-9. doi: 10.1097/00000421-199912000-00002.
This study investigates the clinical utility of squamous cell carcinoma antigen (SCC-Ag), circulating immune complexes (CIC), and immunoglobulins (IgA, IgG, IgM) in the diagnosis, monitoring, and prognosis of 117 squamous cell carcinoma of the head and neck (SCC-HN) patients having local and/or systemic treatment. Serum marker levels were measured in a prospective study. SCC-Ag was positive in 28.2% of patients, the CIC in 63.2%, the IgA in 11.1%, the IgG in 15.4%, and the IgM in 9.44%. Statistically significant correlation was found between the initial SCC-Ag levels and tumor localization, whereas the CIC levels were increasing significantly with progressing disease stages. It was also found that the significant decrease of SCC-Ag, IgA, and CIC levels at the end of treatment was correlated with an increased incidence of disease-free status. The initial values of IgG and the disease stage were significantly correlated with a favorable treatment outcome. The pretreatment elevated SCC-Ag and IgM serum values showed a significant trend to predict a disease progression. Using a Cox proportional hazards model the IgG serum values, the primary site, and the disease stage were significant predictors for time to progression. The significant decrease of SCC-Ag, IgA, and CIC values at the completion of treatment was correlated with an increased incidence of disease-free status. This study indicates that only the estimation of SCC-Ag and in some degree the IgM and/or IgG is a potential tool for monitoring the efficacy of treatment or disease recurrence in SCC-HN.
本研究调查了鳞状细胞癌抗原(SCC-Ag)、循环免疫复合物(CIC)和免疫球蛋白(IgA、IgG、IgM)在117例接受局部和/或全身治疗的头颈部鳞状细胞癌(SCC-HN)患者的诊断、监测及预后中的临床应用价值。在一项前瞻性研究中测定了血清标志物水平。SCC-Ag在28.2%的患者中呈阳性,CIC在63.2%的患者中呈阳性,IgA在11.1%的患者中呈阳性,IgG在15.4%的患者中呈阳性,IgM在9.44%的患者中呈阳性。发现初始SCC-Ag水平与肿瘤定位之间存在统计学显著相关性,而CIC水平随着疾病分期进展而显著升高。还发现治疗结束时SCC-Ag、IgA和CIC水平的显著下降与无病状态发生率增加相关。IgG的初始值与疾病分期与良好的治疗结果显著相关。治疗前升高的SCC-Ag和IgM血清值显示出预测疾病进展的显著趋势。使用Cox比例风险模型,IgG血清值、原发部位和疾病分期是进展时间的显著预测因素。治疗完成时SCC-Ag、IgA和CIC值的显著下降与无病状态发生率增加相关。本研究表明,仅SCC-Ag的评估以及在一定程度上IgM和/或IgG的评估是监测SCC-HN治疗疗效或疾病复发的潜在工具。