Daver A, Dalifard I, Pons-Anicet D, Krebs B P, Gosselin P, Cazin J L, Ricolleau G, Gaillard G, Gachon F, Goussard J
Laboratoire radio-immunologie, Centre Paul-Papin, Angers, France.
Bull Cancer. 1990;77(8):781-92.
A multicenter and retrospective study of the diagnosis value of SCC-TA4 in squamous cell carcinomas of 4 localisations was made with the 2 thresholds of 2 and 2.5 ng/ml. However, 3.1% of controls have a SCC value above 2.5 ng/ml. Sixteen benign gynecologic pathologies had no positive level. The benign digestive (N = 73), bronchial (N = 345) pathologies and no squamous cell carcinomas (N = 93, N = 220 respectively), had SCC-TA4 mean levels significantly lower than corresponding squamous cell carcinomas (N = 153, N = 128 respectively). Sensitivity of the test varied from 40% in the squamous cell carcinomas of the lung, to 72% in the squamous cell carcinomas of the uterine cervix. Specificity was always very high and varied from 91% in the SCC of lung, to 100% in the SCC of uterine cervix. For the SCC of uterine cervix, oesophagus and head and neck, the mean values and incidence of positive levels increased significantly with increasing tumor size and advancing disease stage. For the SCC of uterine cervix, mean SCC-TA4 levels and percentages of positive levels above 2 ng/ml were significantly higher for the patients with recurrence (22.5 +/- 4.6 ng/ml; 76%) or with metastasis appearance (23.6 +/- 5.4 ng/ml; 77%) than for the patients in remission (less than 1.5 ng/ml; 0%). In the SCC of oesophagus, we report levels before treatment that are significantly higher for the patients with metastasis at the first attempt (4.2 +/- 5.1 ng/ml; 59%), and an elevated SCC level at the diagnosis evoked a SCC of lung already disseminated (8.8 +/- 12.1 ng/ml; 50%) that will fail to respond to treatment (4.0 +/- 4.2 ng/ml; 48%).
采用2 ng/ml和2.5 ng/ml这两个阈值,对SCC-TA4在4种不同部位鳞状细胞癌中的诊断价值进行了一项多中心回顾性研究。然而,3.1%的对照者SCC值高于2.5 ng/ml。16例良性妇科病变无阳性水平。良性消化系统病变(n = 73)、支气管病变(n = 345)以及无鳞状细胞癌(分别为n = 93、n = 220)的SCC-TA4平均水平显著低于相应的鳞状细胞癌(分别为n = 153、n = 128)。该检测的敏感性在肺癌鳞状细胞癌中为40%,在子宫颈鳞状细胞癌中为72%。特异性始终很高,在肺癌SCC中为91%,在子宫颈SCC中为100%。对于子宫颈、食管和头颈部的SCC,平均水平和阳性水平的发生率随肿瘤大小增加和疾病分期进展而显著升高。对于子宫颈SCC,复发患者(22.5±4.6 ng/ml;76%)或出现转移的患者(23.6±5.4 ng/ml;77%)的SCC-TA4平均水平和高于2 ng/ml的阳性水平百分比显著高于缓解期患者(低于1.5 ng/ml;0%)。在食管SCC中,我们报告初次就诊时有转移的患者治疗前水平显著更高(4.2±5.1 ng/ml;59%),且诊断时SCC水平升高提示已发生肺转移的SCC(8.8±12.1 ng/ml;50%),此类患者对治疗无反应(4.0±4.2 ng/ml;48%)。