Ogino I, Nakayama H, Kitamura T, Okamoto N, Inoue T
Department of Radiology, Yokohama City University, Yokohama, Japan.
Int J Gynecol Cancer. 2005 Jul-Aug;15(4):630-8. doi: 10.1111/j.1525-1438.2005.00119.x.
The objective of this study was to examine the clinical benefits of routine squamous cell carcinoma antigen (SCC-ag) monitoring of patients with locally advanced cervical cancer. Recurrent disease occurred in 99 uterine cervical cancer patients with elevated pretreatment SCC-ag before primary radiotherapy. Elevated SCC-ag levels persisted in 23 patients after primary radiotherapy (group 1), and SCC-ag was normalized in 76 patients after primary radiotherapy (group 2). The overall survival (OS) rate was higher for patients with SCC-ag elevation as the first sign than for patients with recurrence predicted by other modalities for group 2 patients (P = 0.033). The prediction of isolated para-aortic node recurrence significantly correlated with SCC-ag elevation as an initial sign (P = 0.001). The SCC-ag level before primary radiotherapy (> or = 10.8 ng/mL) significantly affected recurrence predicted by SCC-ag elevation as an initial sign (P = 0.002). For multivariate analysis, the presence of para-aortic node recurrence was statistically significant in OS (P < 0.0001). Routine SCC-ag monitoring of patients with carcinoma of the uterine cervix can lead to the early diagnosis of isolated para-aortic lymph node recurrence, and prolonged survival can be achieved by applying radiation therapy to the para-aortic region. To reduce the number of patients monitored for SCC-ag, we recommend monitoring group 2 patients with pretreatment SCC-ag level before primary radiotherapy > or = 10.8 ng/mL.
本研究的目的是探讨对局部晚期宫颈癌患者进行常规鳞状细胞癌抗原（SCC-ag）监测的临床益处。99例子宫颈癌患者在初次放疗前SCC-ag预处理水平升高，出现了疾病复发。23例患者在初次放疗后SCC-ag水平持续升高（第1组），76例患者在初次放疗后SCC-ag水平恢复正常（第2组）。对于第2组患者，以SCC-ag升高为首个体征的患者的总生存率（OS）高于通过其他方式预测复发的患者（P = 0.033）。孤立性主动脉旁淋巴结复发的预测与以SCC-ag升高为初始体征显著相关（P = 0.001）。初次放疗前的SCC-ag水平（≥10.8 ng/mL）显著影响以SCC-ag升高为初始体征预测的复发（P = 0.002）。对于多因素分析，主动脉旁淋巴结复发的存在在总生存率方面具有统计学意义（P < 0.0001）。对子宫颈癌患者进行常规SCC-ag监测可实现孤立性主动脉旁淋巴结复发的早期诊断，并且通过对主动脉旁区域进行放射治疗可实现生存期延长。为减少SCC-ag监测的患者数量，我们建议对初次放疗前预处理SCC-ag水平≥10.8 ng/mL的第2组患者进行监测。
