Departments of Tumor Markers, Maria Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland.
Int J Gynecol Cancer. 2010 May;20(4):588-92. doi: 10.1111/IGC.0b013e3181d5c27a.
The purpose of this study was to answer the question whether the measurement of the pretreatment tumor markers and cytokine levels would be of clinical use in patients with cervical adenocarcinoma.
CA-125, carcinoembryonic antigen (CEA), and squamous cell carcinoma (SCC), as well as interleukin 6 (IL-6), IL-8, vascular endothelial growth factor, IL-1 receptor antagonist, soluble tumor necrosis factor receptor type I (sTNF RI), and sTNF RII, were assessed in the sera of 120 cervical adenocarcinoma patients.
CA-125 presented a better diagnostic sensitivity than did CEA and SCC, whereas the concentration of most cytokines, except for sTNF RII, revealed higher sensitivity, than did the standard tumor markers. The highest sensitivity was found for sTNF RI. The concentrations of the examined parameters were found to be significantly higher in patients with advanced stage (IIB-IV) as compared with patients with I-IIA stage. [Float1]Serum concentration of IL-6 was the only one that differs significantly, depending on the histological grade. During the 3-year follow-up, 25 patients relapsed, and 73 patients were disease-free. Significantly higher pretreatment serum concentrations of the examined parameters (except for SCC and IL-1 receptor antagonist) were found in patients who developed recurrences. Soluble tumor necrosis factor receptor type I and CA-125 were found to present the highest sensitivity, with areas under the receiver operating characteristic curve of 0.833 and 0.809, respectively. As the result of univariate analysis, CA-125, CEA, sTNF RII, IL-6, sTNF RI, and clinical stage were considered factors of poor prognosis. Multivariate analysis has proven that CA-125 and clinical stage were the only significant independent prognostic factors of the disease-free survival.
CA-125 is an independent prognostic factor for disease-free survival. Our results have also demonstrated that sTNF RI is probably the most useful marker in cervical adenocarcinoma patients, especially in the early stages of disease.
本研究旨在回答以下问题：在患有宫颈癌的患者中，术前肿瘤标志物和细胞因子水平的测量是否具有临床意义。
评估了 120 例宫颈癌患者血清中的 CA-125、癌胚抗原（CEA）和鳞状细胞癌（SCC），以及白细胞介素 6（IL-6）、白细胞介素 8（IL-8）、血管内皮生长因子、白细胞介素 1 受体拮抗剂、可溶性肿瘤坏死因子受体 I（sTNF RI）和可溶性肿瘤坏死因子受体 II（sTNF RII）。
CA-125 的诊断敏感性优于 CEA 和 SCC，而大多数细胞因子的浓度，除 sTNF RII 外，均高于标准肿瘤标志物。sTNF RI 的敏感性最高。与 I-IIA 期患者相比，晚期（IIB-IV 期）患者的检查参数浓度显著升高。[Float1]血清 IL-6 浓度是唯一根据组织学分级显著不同的参数。在 3 年的随访中，有 25 例患者复发，73 例患者无病。复发患者的术前血清检查参数浓度显著升高（除 SCC 和 IL-1 受体拮抗剂外）。可溶性肿瘤坏死因子受体 I 和 CA-125 的敏感性最高，ROC 曲线下面积分别为 0.833 和 0.809。单因素分析结果表明，CA-125、CEA、sTNF RII、IL-6、sTNF RI 和临床分期是预后不良的因素。多因素分析证明，CA-125 和临床分期是无病生存的唯一独立预后因素。
CA-125 是无病生存的独立预后因素。我们的研究结果还表明，sTNF RI 可能是宫颈癌患者最有用的标志物，尤其是在疾病的早期阶段。
