Section for Clinical Epidemiology and Biostatistics, and Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi District, Bangkok 10400, Thailand.
Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi District, Bangkok 10400, Thailand.
Gynecol Oncol. 2018 Jul;150(1):190-200. doi: 10.1016/j.ygyno.2018.03.056. Epub 2018 Mar 29.
The aim of this systematic review and meta-analysis was to pool association effects of serum squamous cell carcinoma antigen (SCC-Ag) on recurrence and mortality in mainly squamous cell cervical cancer patients.
MEDLINE and Scopus databases were searched up to June 29, 2016. Studies assessing effects of SCC-Ag on recurrence and death in cervical cancer patients were included. Data extraction was independently performed by two reviewers. A meta-analysis was applied for pooling the effects (i.e., risk ratio (RR), hazard ratio (HR), and unstandardized mean difference (USMD)) of SCC-Ag measured before and after treatment on recurrence and death.
A total of 61 studies were included. For pretreatment SCC-Ag and recurrence, the pooled RR, HR, and USMD for high versus low serum SCC-Ag were 2.44(95% CI: 1.91, 3.13), 2.23(95% CI: 2.03, 2.45), -7.7(95% CI: -31.7, 16.4), respectively. The corresponding effects for the posttreatment period were 3.91(95% CI: 2.96, 5.16), 3.14(95% CI: 1.29, 7.65), and 3.2(95% CI: -10.6, 17.0), respectively. In addition, patients with high level of pretreatment serum SCC-Ag were also at a higher risk for death than patients with low serum SCC-Ag with a pooled RR of 3.66(95% CI: 2.24, 5.98), pooled HR of 2.50(95% CI: 1.85, 3.37), and pooled USMD of 7.10(95% CI: 4.26, 9.94). The posttreatment serum SCC-Ag effects also reflected a similar trend.
The serum SCC-Ag was consistently associated with recurrence and mortality of newly diagnosed cervical cancer. This marker may be useful in monitoring disease progression in cervical cancer patients. Prospero registration number is: CRD42016044024.
本系统评价和荟萃分析旨在汇总血清鳞状细胞癌抗原（SCC-Ag）对主要为鳞状细胞宫颈癌患者复发和死亡的关联效应。
检索 MEDLINE 和 Scopus 数据库，截至 2016 年 6 月 29 日。纳入评估 SCC-Ag 对宫颈癌患者复发和死亡影响的研究。由两位审阅者独立进行数据提取。应用荟萃分析汇总治疗前后 SCC-Ag 测量值对复发和死亡的效应（即风险比（RR）、风险比（HR）和未标准化均数差（USMD））。
共纳入 61 项研究。对于治疗前 SCC-Ag 和复发，高血清 SCC-Ag 与低血清 SCC-Ag 相比，汇总 RR、HR 和 USMD 分别为 2.44（95%CI：1.91，3.13）、2.23（95%CI：2.03，2.45）和-7.7（95%CI：-31.7，16.4）。治疗后相应的效应为 3.91（95%CI：2.96，5.16）、3.14（95%CI：1.29，7.65）和 3.2（95%CI：-10.6，17.0）。此外，高血清 SCC-Ag 水平的患者与低血清 SCC-Ag 患者相比，死亡风险更高，汇总 RR 为 3.66（95%CI：2.24，5.98），汇总 HR 为 2.50（95%CI：1.85，3.37），汇总 USMD 为 7.10（95%CI：4.26，9.94）。治疗后血清 SCC-Ag 的效应也反映出类似的趋势。
血清 SCC-Ag 与新诊断的宫颈癌患者的复发和死亡始终相关。该标志物可能有助于监测宫颈癌患者的疾病进展。PROSPERO 注册号为：CRD42016044024。
