Lin H, ChangChien C C, Huang E Y, Tseng C W, Eng H L, Huang C C
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Acta Obstet Gynecol Scand. 2000 Feb;79(2):140-4. doi: 10.1034/j.1600-0412.2000.079002140.x.
To evaluate whether the presence of pelvic lymph node metastasis can be predicted by pretreatment squamous cell carcinoma antigen (SCC-Ag) levels in early stage squamous cervical carcinoma.
Between 1994 and 1998, 284 patients with stage Ib and IIa cervical squamous cell carcinoma undergoing radical hysterectomy had preoperative SCC-Ag determination. The correlation between clinicopathological findings on SCC-Ag levels were examined. The Mann-Whitney U test was used to statistically analyze differences between node positive and negative patients. Multiple regression analysis and a multiple logistic model were employed to examine the effect of clinicopathological findings on SCC-Ag levels.
Of the 284 patients, 56 patients were found to have nodal metastasis. Median serum levels and 90% ranges of SCC-Ag were 0.74 microg/l (0.5-7.8) in the 228 nodal negative patients and 4.33 microg/l (0.5-48.5) in the 56 nodal positive patients (p<0.001). Lymph node metastasis and tumor size were found to have a significant impact on SCC-Ag levels. Around 86% of the patients with SCC-Ag levels below 8 microg/l showed no nodal metastasis, while about 65% of the patients with serum levels above 8 microg/l exhibited nodal metastasis. Multivariate analyses confirmed that only lymph node metastasis had a significant impact on the SCC-Ag levels exceeding 8 microg/l.
For predicting nodal metastasis preoperatively, SCC-Ag levels greater than 8 microg/ l can be considered a high-risk zone for nodal metastasis.
评估早期宫颈鳞状细胞癌患者术前鳞状细胞癌抗原（SCC-Ag）水平能否预测盆腔淋巴结转移的存在。
1994年至1998年间，284例接受根治性子宫切除术的Ib期和IIa期宫颈鳞状细胞癌患者进行了术前SCC-Ag测定。检查了SCC-Ag水平与临床病理结果之间的相关性。采用曼-惠特尼U检验对淋巴结阳性和阴性患者之间的差异进行统计学分析。采用多元回归分析和多元逻辑模型来检验临床病理结果对SCC-Ag水平的影响。
284例患者中，56例发现有淋巴结转移。228例淋巴结阴性患者的SCC-Ag中位数血清水平及90%范围为0.74μg/l（0.5 - 7.8），56例淋巴结阳性患者为4.33μg/l（0.5 - 48.5）（p<0.001）。发现淋巴结转移和肿瘤大小对SCC-Ag水平有显著影响。SCC-Ag水平低于8μg/l的患者中约86%无淋巴结转移，而血清水平高于8μg/l的患者中约65%有淋巴结转移。多变量分析证实，只有淋巴结转移对超过8μg/l的SCC-Ag水平有显著影响。
对于术前预测淋巴结转移，SCC-Ag水平大于8μg/l可被视为淋巴结转移的高危区域。
