Jeong Bae Kwon, Choi Doo Ho, Huh Seung Jae, Park Won, Bae Duk Soo, Kim Byoung-Gie
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Radiat Oncol J. 2011 Sep;29(3):191-8. doi: 10.3857/roj.2011.29.3.191. Epub 2011 Sep 30.
Although the role of squamous cell carcinoma antigen (SCC-Ag) as a predictive and prognostic factor for uterine cervical cancer has been identified in previous studies, 1) the effective patient group of screening for recurrence with SCC-Ag, 2) the relationship between SCC-Ag and recurrence site, and 3) the relationship between the change of SCC-Ag and treatment outcome or recurrence have not been described.
The study included 506 patients with histologically proven uterine cervical cancer between January 1994 and December 2010. We determining the serum SCC-Ag level before treatment and after treatment, and conducted a retrospective review of the patients' records. We evaluated the sensitivity and specificity of SCC-Ag for the detection of tumor recurrence by comparing biochemical recurrence with clinical recurrence.
The pretreatment SCC-Ag level and the proportion of patients over 1.5 ng/mL were higher in poor prognostic patient group. In the univariate and multivariate analysis, pretreatment SCC-Ag showed a statistically significant correlation with tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology. In patients with biochemical recurrence vs. those without, 5-year DFS and OS were 27.6 vs. 92.7% (p ≤ 0.001) and 53.7 vs. 92.5% (p ≤ 0.001), respectively.
Our study reconfirmed the known function of pretreatment SCC-Ag, but could not confirm the function of biochemical response as a predictive factor for treatment and as a prognostic factor. There was no statistically significant relationship between SCC-Ag level and recurrence site. We confirmed the role of SCC-Ag as a follow-up tool for recurrence of disease and which patient groups SCC-Ag was more useful for.
尽管先前的研究已确定鳞状细胞癌抗原(SCC-Ag)作为子宫颈癌预测和预后因素的作用,但1)SCC-Ag筛查复发的有效患者群体,2)SCC-Ag与复发部位之间的关系,以及3)SCC-Ag变化与治疗结果或复发之间的关系尚未见描述。
本研究纳入了1994年1月至2010年12月间506例经组织学证实的子宫颈癌患者。我们测定了治疗前和治疗后的血清SCC-Ag水平,并对患者记录进行了回顾性分析。通过比较生化复发与临床复发,我们评估了SCC-Ag检测肿瘤复发的敏感性和特异性。
预后较差的患者组中,治疗前SCC-Ag水平及超过1.5 ng/mL的患者比例更高。在单因素和多因素分析中,治疗前SCC-Ag与肿瘤大小、国际妇产科联盟(FIGO)分期、病理具有统计学显著相关性。生化复发患者与未复发患者相比,5年无病生存率(DFS)分别为27.6%和92.7%(p≤0.001),总生存率(OS)分别为53.7%和92.5%(p≤0.001)。
我们的研究再次证实了治疗前SCC-Ag的已知功能,但未能证实生化反应作为治疗预测因素和预后因素的功能。SCC-Ag水平与复发部位之间无统计学显著关系。我们证实了SCC-Ag作为疾病复发随访工具的作用以及对哪些患者群体更有用。