Bae S N, Namkoong S E, Jung J K, Kim C J, Park J S, Kim J W, Lee J M, Kim S J
Department of Obstetrics and Gynecology, Catholic University Medical College, Seoul, Korea.
Gynecol Oncol. 1997 Mar;64(3):418-24. doi: 10.1006/gyno.1996.4589.
Sixty-seven patients with squamous cell carcinoma of the uterine cervix (FIGO Stages IB2, IIA, and IIB) were reviewed to evaluate the pretreatment level of squamous cell carcinoma antigen (SCC) and carcinoembryonic antigen (CEA) which may be used to predict a subset of patients with poor prognosis. The rate of pathologic pretreatment serum level of SCC increased significantly in cases with Stage IIB compared to that of Stages IB2 and IIA (50% versus 16.3%). The rate of pathologic pretreatment serum level of CEA did not show any difference between these two groups (29.2% versus 30.2%). The 48-month disease-free survival for patients with pathologic pretreatment serum levels for one or both tumor-associated antigens (TAAs) was 40.0% versus 91.7% for patients with normal levels (log-rank test, P < 0.005) in Stages IB2 and IIA. Patients who had a pathologic pretreatment serum level for one or both TAAs showed higher incidence of lymph node metastasis than patients with normal levels (36.7% versus 10.8%). The patients who had pathologic pretreatment serum levels for both TAAs and lymph node metastasis have the poorest prognosis. The pretreatment serum levels for one or both TAAs make it possible to predict the clinical response to neoadjuvant chemotherapy consisting of cis-platinum (DDP) and 5-fluorouracil (5-FU). Our findings suggest that pretreatment of SCC in conjunction with CEA is a valuable tumor marker to predict the prognosis of squamous cell carcinoma of the uterine cervix and to foresee a clinical response to subsequent neoadjuvant chemotherapy.
回顾了67例子宫颈鳞状细胞癌患者（国际妇产科联盟（FIGO）分期为IB2、IIA和IIB期），以评估鳞状细胞癌抗原（SCC）和癌胚抗原（CEA）的预处理水平，这两种抗原可用于预测预后不良的患者亚组。与IB2期和IIA期相比，IIB期病例的预处理血清SCC病理水平发生率显著升高（50%对16.3%）。两组之间CEA的预处理血清病理水平发生率没有差异（29.2%对30.2%）。在IB2期和IIA期，一种或两种肿瘤相关抗原（TAA）预处理血清水平异常的患者48个月无病生存率为40.0%，而水平正常的患者为91.7%（对数秩检验，P<0.005）。一种或两种TAA预处理血清水平异常的患者淋巴结转移发生率高于水平正常的患者（36.7%对10.8%）。两种TAA预处理血清水平异常且有淋巴结转移的患者预后最差。一种或两种TAA的预处理血清水平能够预测对由顺铂（DDP）和5-氟尿嘧啶（5-FU）组成的新辅助化疗的临床反应。我们的研究结果表明，SCC与CEA联合进行预处理是一种有价值的肿瘤标志物，可用于预测子宫颈鳞状细胞癌的预后，并预见对后续新辅助化疗的临床反应。
