Takeuchi Susumu, Nonaka Makoto, Kadokura Mitsutaka, Takaba Toshihiro
First Department of Surgery, Showa University School of Medicine, Hatanodai, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2003 Apr;9(2):98-104.
The serum concentrations of squamous cell carcinoma antigen (SCC-Ag) obtained from 124 surgically treated primary non-small cell lung cancer patients, including 75 adenocarcinomas (AD) and 49 squamous cell carcinomas (SQ), were studied. The changes in the SCC-Ag concentration, which were obtained before and one month after surgery, were analyzed. The 5-year survival rate of the patients with AD who were positive for SCC-Ag preoperatively (32%) was lower than that for those who were negative for SCC-Ag preoperatively (57%, p<0.05). Meanwhile, in those with SQ, the 5-year survival rate of those who were positive for SCC-Ag preoperatively (59%) was not different when compared with those who were negative for SCC-Ag preoperatively (73%). The 5-year survival rate of patients with AD who were positive for SCC-Ag preoperatively and negative postoperatively was 53% versus 17% for those who remained positive postoperatively (p<0.05). In those with SQ, the 5-year survival rate of those who were positive for SCC-Ag preoperatively and negative postoperatively was 76% while it was 0% for those who remained positive postoperatively (p<0.01). In patients with negative SCC-Ag postoperatively, 5-year survival rates were not different between the patients who had positive antigen preoperatively and the patients who had negative antigen preoperatively both in AD (53% and 57%, respectively) and SQ (76% and 75%, respectively). In conclusion, though SCC-Ag is widely used for SQ, preoperative SCC-Ag did not reflect the prognosis. In AD, the survival rate was lower in antigen-positive than antigen-negative patients. Survival rate was higher in antigen-positive patients who became antigen-negative following resection than in patients who remained antigen-positive for both AD and SQ. In the patients who were negative for SCC-Ag postoperatively, survival was the same regardless of the preoperative SCC-Ag positivity in both AD and SQ.
对124例接受手术治疗的原发性非小细胞肺癌患者的血清鳞状细胞癌抗原（SCC-Ag）浓度进行了研究，其中包括75例腺癌（AD）和49例鳞状细胞癌（SQ）。分析了手术前和术后1个月时SCC-Ag浓度的变化。术前SCC-Ag呈阳性的AD患者的5年生存率（32%）低于术前SCC-Ag呈阴性的患者（57%，p<0.05）。同时，在SQ患者中，术前SCC-Ag呈阳性的患者的5年生存率（59%）与术前SCC-Ag呈阴性的患者（73%）相比无差异。术前SCC-Ag呈阳性且术后呈阴性的AD患者的5年生存率为53%，而术后仍呈阳性的患者为17%（p<0.05）。在SQ患者中，术前SCC-Ag呈阳性且术后呈阴性的患者的5年生存率为76%，而术后仍呈阳性的患者为0%（p<0.01）。术后SCC-Ag呈阴性的患者中，术前抗原呈阳性的AD患者和术前抗原呈阴性的患者的5年生存率无差异（分别为53%和57%），SQ患者中也是如此（分别为76%和75%）。总之，尽管SCC-Ag广泛应用于SQ，但术前SCC-Ag并不能反映预后。在AD中，抗原阳性患者的生存率低于抗原阴性患者。对于AD和SQ，切除后抗原由阳性转为阴性的患者的生存率高于仍为抗原阳性的患者。术后SCC-Ag呈阴性的患者中，无论术前SCC-Ag是否为阳性，AD和SQ的生存率相同。
