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治疗前鳞状细胞癌抗原升高表明接受根治性放疗的宫颈癌患者治疗结果不佳。

Elevated pretreatment squamous cell Carcinoma Antigen indicates unfavorable treatment outcomes in cervical cancer patients receiving definitive radiotherapy.

作者信息

Liu Dingchao, Wang Weiping, Zeng Zheng, Liu Xiaoliang, Zhou Yuncan, Wang Chen, Li Xiaoyan, Hu Ke

机构信息

The Institutional Affiliation: Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.

出版信息

Precis Radiat Oncol. 2023 Jul 16;7(3):173-180. doi: 10.1002/pro6.1202. eCollection 2023 Sep.

Abstract

OBJECTIVE

To investigate the prognostic value of pretreatment squamous cell carcinoma antigen (SCC Ag) levels for treatment failure prediction in patients with cervical cancer.

METHODS

A quantity of 985 patients satisfying the eligibility criteria were included, with a median follow-up duration of 63.7 months. The optimal cutoff value for pretreatment SCC Ag levels was verified by the receiver operating characteristic (ROC) curve. Five-year disease-free survival (DFS), overall survival (OS), and local control (LC) rates were evaluated utilizing the Kaplan-Meier method. Log-rank test and Cox proportional hazards model was implemented to recognize independent prognostic predictors.

RESULTS

The optimal pretreatment SCC Ag cutoff value was 8.85 ng/mL. Patients with pretreatment SCC Ag levels ≥ 8.85 ng/mL presented significantly inferior 5-year DFS (63.8% vs. 81.8%), OS (71.7% vs. 88.7%), and LC (80.5% vs. 91.0%) compared to those with levels < 8.85 ng/mL (all < 0.001). The results of the multivariate analysis indicated that the pretreatment SCC Ag level was an independent predictor of treatment failure (HR,1.772; 95% CI, 1.366 to 2.299; < 0.001).

CONCLUSION

Pretreatment SCC Ag is an effective prognostic factor in patients with cervical cancer undergoing definitive radiotherapy, with a ROC-identified cutoff value of 8.85 ng/mL and elevated SCC Ag indicates unfavorable outcomes.

摘要

目的

探讨治疗前鳞状细胞癌抗原(SCC Ag)水平对宫颈癌患者治疗失败预测的预后价值。

方法

纳入985例符合入选标准的患者,中位随访时间为63.7个月。通过受试者工作特征(ROC)曲线验证治疗前SCC Ag水平的最佳临界值。采用Kaplan-Meier法评估5年无病生存率(DFS)、总生存率(OS)和局部控制率(LC)。采用对数秩检验和Cox比例风险模型识别独立的预后预测因素。

结果

治疗前SCC Ag的最佳临界值为8.85 ng/mL。与治疗前SCC Ag水平<8.85 ng/mL的患者相比,治疗前SCC Ag水平≥8.85 ng/mL的患者5年DFS(63.8%对81.8%)、OS(71.7%对88.7%)和LC(80.5%对91.0%)均显著较差(均P<0.001)。多因素分析结果表明,治疗前SCC Ag水平是治疗失败的独立预测因素(HR,1.772;95%CI,1.366至2.299;P<0.001)。

结论

治疗前SCC Ag是接受根治性放疗的宫颈癌患者的有效预后因素,ROC确定的临界值为8.85 ng/mL,SCC Ag升高表明预后不良。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/576b/11935056/5ff697dfccab/PRO6-7-173-g001.jpg

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