Kainz C, Sliutz G, Mustafa G, Bieglmayr C, Koelbl H, Reinthaller A, Gitsch G
Department of Gynecology and Obstetrics, University of Vienna Medical School, Austria.
Gynecol Oncol. 1995 Mar;56(3):402-5. doi: 10.1006/gyno.1995.1071.
The purpose of this study was to evaluate the serum tumor markers CYFRA 21-1 and squamous-cell carcinoma antigen (SCC) in the follow-up of squamous-cell cervical cancer patients. One hundred-ninety-three serum samples, which were collected pretherapeutically and during follow-up of 30 patients suffering from squamous-cell cervical cancer FIGO stage III, were analyzed for SCC and CYFRA 21-1. Cutoff values for SCC and CYFRA 21-1 were 3 and 3.3 micrograms/liter, respectively. Fifteen cases were keratinizing and 15 nonkeratinizing squamous-cell carcinomas. Serum tumor marker results were correlated to the results of the clinical and radiologic examinations. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of serum SCC and serum CYFRA 21-1 for the whole study group and separately for the keratinizing and nonkeratinizing squamous-cell carcinoma group. Sensitivity, specificity, PPV, and NPV of serum SCC were 66, 91, 93, and 60%, respectively. Serum CYFRA 21-1 showed a sensitivity of 63%, specificity of 96%, PPV of 96%, and NPV of 59%. The combination of SCC and CYFRA 21-1 increased the sensitivity to 78%, with a specificity, PPV, and NPV of 87, 91, and 69%, respectively. In keratinizing squamous-cell carcinoma serum SCC, CYFRA 21-1 and the combination of both had a sensitivity of 76, 64, and 85%, respectively. In nonkeratinizing squamous-cell carcinoma sensitivity was 58, 61, and 72%, respectively. The detection of cervical cancer recurrences with SCC is improved by the combination with CYFRA 21-1. Especially in nonkeratinizing squamous-cell carcinoma CYFRA 21-1 showed promising results.
本研究旨在评估血清肿瘤标志物细胞角蛋白19片段(CYFRA 21-1)和鳞状细胞癌抗原(SCC)在宫颈鳞状细胞癌患者随访中的作用。收集了193份血清样本,这些样本来自30例国际妇产科联盟(FIGO)III期宫颈鳞状细胞癌患者治疗前及随访期间,对其进行SCC和CYFRA 21-1分析。SCC和CYFRA 21-1的临界值分别为3微克/升和3.3微克/升。其中15例为角化型鳞状细胞癌,15例为非角化型鳞状细胞癌。血清肿瘤标志物结果与临床及影像学检查结果相关。我们计算了整个研究组以及角化型和非角化型鳞状细胞癌组血清SCC和血清CYFRA 21-1的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)。血清SCC的敏感性、特异性、PPV和NPV分别为66%、91%、93%和60%。血清CYFRA 21-1的敏感性为63%,特异性为96%,PPV为96%,NPV为59%。SCC和CYFRA 21-1联合检测使敏感性提高到78%,特异性、PPV和NPV分别为87%、91%和69%。在角化型鳞状细胞癌中,血清SCC、CYFRA 21-1及两者联合检测的敏感性分别为76%、64%和85%。在非角化型鳞状细胞癌中,敏感性分别为58%、61%和72%。SCC与CYFRA 21-1联合检测可提高宫颈癌复发的检出率。尤其是在非角化型鳞状细胞癌中,CYFRA 21-1显示出了良好的结果。