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宫颈癌患者随访期间的鳞状细胞癌抗原(SCC-Ag):在复发早期诊断中的作用。

Squamous cell carcinoma antigen (SCC-Ag) during follow-up of cervical cancer patients: Role in the early diagnosis of recurrence.

作者信息

Salvatici Michela, Achilarre Maria T, Sandri Maria T, Boveri Sara, Vanna Zanagnolo, Landoni Fabio

机构信息

Division of Laboratory Medicine, European Institute of Oncology, Milan, Italy.

Division of Gynaecology, Cervical Cancer Center, European Institute of Oncology, Milan, Italy.

出版信息

Gynecol Oncol. 2016 Jul;142(1):115-119. doi: 10.1016/j.ygyno.2016.04.029. Epub 2016 May 6.

Abstract

OBJECTIVE

The aim of this study was to assess the potential benefit of routine squamous cell carcinoma antigen (SCC-Ag) assessment during follow-up of patients after treatment for early cervical cancer with regard to early diagnosis of cancer recurrence before clinical signs and symptoms occur.

METHODS

All clinical, pathological, and serological data of patients referred to the Department of Gynecologic Oncology between July 1999 and June 2014, were retrospectively collected and analyzed. The SCC-Ag levels of 197 patients with diagnosis of stage I or II cervical squamous carcinoma, were performed.

RESULTS

In the univariate analysis, serum SCC-Ag was not significantly associated with grading (p=0.85), LVSI (p=0.95) and FIGO stage (p=0.83) but it was significantly associated with recurrence of disease (p<0.001). The Cox multivariate analyses showed that serum SCC-Ag level was an independent and statistically significant prognostic factor for OS and PFS. The median time interval between SCC-Ag test and diagnosis of recurrence were 0.3 and 1.8months for positive and negative SCC-Ag groups respectively (p=0.01). Considering patients with recurrence, no significant difference in terms of DFS and OS was found between women with high or low SCC-Ag levels.

CONCLUSIONS

Serum SCC-Ag reflects the response to treatment, and rising antigen levels often precede the clinical detection of recurrent disease, and may lead to early diagnosis. However such an advantage does not seem to improve the cure rate of patients with elevated SCC-Ag levels, most likely due to the lack of curative salvage treatments.

摘要

目的

本研究旨在评估早期宫颈癌患者治疗后随访期间进行常规鳞状细胞癌抗原(SCC-Ag)检测对于在临床体征和症状出现之前早期诊断癌症复发的潜在益处。

方法

回顾性收集并分析了1999年7月至2014年6月转诊至妇科肿瘤学部门的患者的所有临床、病理和血清学数据。对197例诊断为I期或II期宫颈鳞状癌的患者进行了SCC-Ag水平检测。

结果

单因素分析中,血清SCC-Ag与分级(p=0.85)、淋巴血管间隙浸润(LVSI,p=0.95)和国际妇产科联盟(FIGO)分期(p=0.83)无显著相关性,但与疾病复发显著相关(p<0.001)。Cox多因素分析表明,血清SCC-Ag水平是总生存期(OS)和无进展生存期(PFS)的独立且具有统计学意义的预后因素。SCC-Ag检测阳性和阴性组中,SCC-Ag检测与复发诊断之间的中位时间间隔分别为0.3个月和1.8个月(p=0.01)。对于复发患者,SCC-Ag水平高或低的女性在无病生存期(DFS)和总生存期方面未发现显著差异。

结论

血清SCC-Ag反映了对治疗的反应,抗原水平升高通常先于复发性疾病的临床检测,可能有助于早期诊断。然而,这种优势似乎并未提高SCC-Ag水平升高患者的治愈率,很可能是由于缺乏有效的挽救性治疗。

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