Bolger B S, Dabbas M, Lopes A, Monaghan J M
Regional Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead, United Kingdom.
Gynecol Oncol. 1997 May;65(2):309-13. doi: 10.1006/gyno.1997.4619.
Preoperative evaluation of squamous cell carcinoma antigen (SCCa) was performed in 220 patients with surgically treated early-stage carcinoma of the cervix. The median duration of follow-up was 1.9 years. SCCa was significantly higher in tumors with a squamous element (P < 0.001). There was a squamous element in 171 tumors. SCCa was elevated (>2 ng/ml) in 21.6%. Significantly higher levels were associated with stage II disease (P < 0.001), tumors >4-cm size (P < 0.001), and lymph node metastases (P < 0.001). The positive predictive value for lymph node metastases at >2, >4, and >8.6 ng/ml SCCa is 51.4, 70.0, and 100% and the sensitivity is 58.1, 45.2, and 22.6%, respectively. Low SCCa is a poor predictor of absence of lymph node metastasis. The median SCCa for patients who developed tumor recurrence was greater than those who remained disease free (1.7 and 1.0 ng/ml, respectively, P = 0.009); however, in a multivariate analysis only lymph node metastasis and tumor size were of independent prognostic significance (P = 0.002 and P = 0.004, respectively). SCCa level >8.6 ng/ml is highly predictive of lymph nodal disease. There is no independent prognostic significance in patients with early-stage surgically treated cervical carcinoma.
对220例接受手术治疗的早期宫颈癌患者进行了术前鳞状细胞癌抗原（SCCa）评估。中位随访时间为1.9年。在含有鳞状成分的肿瘤中，SCCa显著更高（P<0.001）。171例肿瘤含有鳞状成分。SCCa升高（>2 ng/ml）的占21.6%。较高水平与II期疾病（P<0.001）、肿瘤大小>4 cm（P<0.001）和淋巴结转移（P<0.001）相关。SCCa>2、>4和>8.6 ng/ml时，淋巴结转移的阳性预测值分别为51.4%、70.0%和100%，敏感性分别为58.1%、45.2%和22.6%。低SCCa不是无淋巴结转移的良好预测指标。发生肿瘤复发患者的SCCa中位数高于无疾病复发患者（分别为1.7和1.0 ng/ml，P = 0.009）；然而，多因素分析显示，只有淋巴结转移和肿瘤大小具有独立的预后意义（分别为P = 0.002和P = 0.004）。SCCa水平>8.6 ng/ml对淋巴结疾病具有高度预测性。对于接受手术治疗的早期宫颈癌患者，SCCa无独立的预后意义。
