Maiman M, Feuer G, Fruchter R G, Shaw N, Boyce J
Department Obstetrics and Gynecology, State University of New York-Health Science Center, Brooklyn 11203.
Gynecol Oncol. 1989 Sep;34(3):312-6. doi: 10.1016/0090-8258(89)90164-9.
Squamous cell carcinoma (SCC) antigen (Ag) levels were measured by radioimmunoassay in 64 patients with invasive squamous cell cervical carcinoma and 9 patients with nonsquamous carcinoma before the initiation of treatment. The mean antigen level in the squamous group was 10.5 ng/ml compared with 1.3 ng/ml in the nonsquamous group. In the patients with squamous cell carcinoma, mean SCC Ag level correlated well with stage, except for bulky stage IB tumors (P less than 0.05), where mean level was much higher than expected. Patients with exophytic tumors had significantly higher SCC Ag levels than those with nonexophytic tumors. Follow-up on 62 evaluable patients ranged from 20 to 40 months. The mean pretreatment SCC Ag level for patients free of disease at last contact was 5.6 ng/ml, in contrast to 16.1 ng/ml for those with recurrent disease. Only 32% of patients free of disease had pretreatment levels of 4.0 ng/ml or greater, while 86% of those with recurrent disease had such values (P less than 0.05). Forty patients had follow-up samples drawn 1 to 14 months after treatment. Mean post-treatment SCC Ag levels dropped to 1.8 ng/ml in 21 patients free of disease (73% decrease), but remained elevated at 13.4 ng/ml (17% decrease) in 19 patients with recurrences. The specificity of follow-up SCC Ag levels as a predictive test for outcome was 90%, with a sensitivity of 63%. We conclude that pretreatment SCC Ag levels correlate well with tumor stage, lesion morphology, and extent of disease. SCC antigen levels may be used to follow patients to determine effectiveness of treatment.
采用放射免疫分析法对64例浸润性宫颈鳞状细胞癌患者和9例非鳞状细胞癌患者在治疗开始前检测了鳞状细胞癌（SCC）抗原（Ag）水平。鳞状细胞癌组的平均抗原水平为10.5 ng/ml，而非鳞状细胞癌组为1.3 ng/ml。在鳞状细胞癌患者中，除了巨大的IB期肿瘤（P<0.05），其平均水平远高于预期外，平均SCC Ag水平与分期密切相关。外生性肿瘤患者的SCC Ag水平明显高于非外生性肿瘤患者。对62例可评估患者的随访时间为20至40个月。最后一次随访时无疾病患者的预处理SCC Ag平均水平为5.6 ng/ml，而复发患者为16.1 ng/ml。无疾病患者中只有32%的预处理水平为4.0 ng/ml或更高，而复发患者中有86%具有这样的值（P<0.05）。40例患者在治疗后1至14个月采集了随访样本。21例无疾病患者的治疗后SCC Ag平均水平降至1.8 ng/ml（下降73%），但19例复发患者仍升高至13.4 ng/ml（下降17%）。随访SCC Ag水平作为预后预测指标的特异性为90%，敏感性为63%。我们得出结论，预处理SCC Ag水平与肿瘤分期、病变形态和疾病范围密切相关。SCC抗原水平可用于随访患者以确定治疗效果。
