血清鳞状细胞癌抗原在宫颈鳞状细胞癌诊断、治疗及预后中的临床意义

[Clinical significance of serum squamous cell carcinoma antigen in the diagnosis, treatment and prognosis of cervical squamous cell carcinoma].

作者信息

Luan Xiao-mei, Zhang Yao, Wang Shi-zhuo, Wang Ning, Li Wei, Zhang Qiao, Wei Heng, Zhang Shu-lan

机构信息

Department of Obstetrics & Gynecology, Shengjing Hospital, China Medical University, Shenyang 110004, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 May 22;92(19):1330-3.

PMID:22883121

Abstract

OBJECTIVE

To explore the clinical significance of squamous cell carcinoma antigen (SCC-Ag) in the diagnosis, treatment and prognosis of cervical squamous cell carcinoma.

METHODS

The serum SCC-Ag concentrations were measured for 1195 patients with cervical squamous cell carcinoma, 54 patients with non-squamous cell type cervical cancer, 325 patients with cervical intraepithelial neoplasm and 69 healthy women treated at Gynecology Ward of Shengjing Hospital, China Medical University from August 2008 to October 2010. And the correlations with their clinical pathological features of squamous cell carcinoma were analyzed and the changes in the diagnosis, treatment and prognosis monitored.

RESULTS

Serum SCC-Ag in patients with cervical squamous cell carcinoma showed a sensitivity of 62.32% and a specificity of 90.10% with the optimal cutoff point of diagnosis at 1.45 µg/L. The differences of pretreatment serum SCC-Ag levels were statistically significant in clinical stage, histological differentiation, depth of invasion and lymph node metastasis (P < 0.01). The posttreatment serum SCC-Ag levels of 106 patients undergoing radical surgery and 264 patients on chemotherapy significantly decreased and were significant different with their pretreatment levels (P < 0.05). There was no relationship of serum SCC-Ag levels and human papillomavirus (HPV) opportunistic infection (all P > 0.05). The best threshold values of pretreatment serum SCC-Ag concentration for predicting early postoperative cervical lymph node metastasis and prognosis of cervical cancer were 2.15 and 12.1 µg/L respectively.

CONCLUSION

As a relatively specific tumor maker for cervical squamous cell carcinoma, squamous cell carcinoma antigen is correlated with clinicopathological features of cervical squamous cell carcinoma. And it has important clinical reference values in the diagnosis, prognosis, follow-up evaluation and treatment monitoring of cervical squamous cell carcinoma.

摘要

目的

探讨鳞状细胞癌抗原（SCC-Ag）在宫颈鳞状细胞癌诊断、治疗及预后中的临床意义。

方法

对2008年8月至2010年10月在中国医科大学附属盛京医院妇科病房收治的1195例宫颈鳞状细胞癌患者、54例非鳞状细胞型宫颈癌患者、325例宫颈上皮内瘤变患者及69例健康女性测定血清SCC-Ag浓度。分析其与宫颈鳞状细胞癌临床病理特征的相关性，并监测诊断、治疗及预后的变化。

结果

宫颈鳞状细胞癌患者血清SCC-Ag诊断的敏感性为62.32%，特异性为90.10%，最佳诊断临界值为1.45μg/L。治疗前血清SCC-Ag水平在临床分期、组织学分级、浸润深度及淋巴结转移方面差异有统计学意义（P<0.01）。106例行根治性手术患者及264例化疗患者治疗后血清SCC-Ag水平明显下降，与治疗前水平差异有统计学意义（P<0.05）。血清SCC-Ag水平与人类乳头瘤病毒（HPV）机会性感染无关（均P>0.05）。预测宫颈癌术后早期淋巴结转移及预后的治疗前血清SCC-Ag浓度最佳阈值分别为2.15和12.1μg/L。