Kikkawa F, Nawa A, Tamakoshi K, Ishikawa H, Kuzuya K, Suganuma N, Hattori S, Furui K, Kawai M, Arii Y
Department of Obstetrics and Gynecology, Nagoya University School of Medicine, Japan.
Cancer. 1998 Jun 1;82(11):2249-55. doi: 10.1002/(sici)1097-0142(19980601)82:11<2249::aid-cncr21>3.0.co;2-t.
The prognoses of patients with squamous cell carcinoma of the ovary are quite poor. However, preoperative diagnosis is difficult due to the rarity of this tumor and its similarity to mature cystic teratoma (MCT). The objective of this study was to assess the value of tumor markers and clinical characteristics in making a differential diagnosis between MCT and squamous cell carcinoma arising from MCT.
Between September 1979 and June 1996, 37 patients with ovarian squamous cell carcinoma arising from MCT were treated by the Tokai Ovarian Tumor Study Group. The authors evaluated tumor markers, tumor size, and age as parameters for differentiation between MCT and squamous cell carcinoma arising from MCT. Diagnostic efficiency was calculated as the sensitivity multiplied by the specificity.
There were significant differences (P < or = 0.0002) in age, tumor size, and levels of squamous cell carcinoma antigen (SCC), CA125, and CEA, as well as a significant difference (P < or = 0.0396) in the CA19-9 level between MCT and squamous cell carcinoma arising from MCT. Diagnostic efficiency was highest for SCC (63.0%), followed by CA125 (50.7%). Receiver operating characteristic (ROC) curves demonstrated that CEA was the best screening marker for squamous cell carcinoma arising from MCT, whereas age and tumor size were better markers than CA125 or CA19-9. The optimal cutoff values for age and tumor size were 45 years and 99 mm, respectively, according to ROC analysis.
These findings demonstrate that age and tumor size are important factors in making a differential diagnosis. In addition, SCC and CEA levels should be measured in patients age 45 years or older who have an MCT-like ovarian tumor larger than 99 mm in greatest dimension.
卵巢鳞状细胞癌患者的预后相当差。然而，由于这种肿瘤罕见且与成熟囊性畸胎瘤（MCT）相似，术前诊断困难。本研究的目的是评估肿瘤标志物和临床特征在鉴别MCT与由MCT发生的鳞状细胞癌中的价值。
1979年9月至1996年6月间，东海卵巢肿瘤研究组对37例由MCT发生的卵巢鳞状细胞癌患者进行了治疗。作者评估了肿瘤标志物、肿瘤大小和年龄，将其作为鉴别MCT与由MCT发生的鳞状细胞癌的参数。诊断效率通过敏感性乘以特异性来计算。
MCT与由MCT发生 的鳞状细胞癌在年龄、肿瘤大小、鳞状细胞癌抗原（SCC）、CA125和CEA水平上存在显著差异（P≤0.0002），在CA19-9水平上也存在显著差异（P≤0.0396）。SCC的诊断效率最高（63.0%），其次是CA125（50.7%）。受试者工作特征（ROC）曲线表明，CEA是筛查由MCT发生的鳞状细胞癌的最佳标志物，而年龄和肿瘤大小比CA125或CA19-9是更好的标志物。根据ROC分析，年龄和肿瘤大小的最佳截断值分别为45岁和99mm。
这些发现表明年龄和肿瘤大小是进行鉴别诊断的重要因素。此外，对于最大径大于99mm的疑似MCT的45岁及以上卵巢肿瘤患者，应检测SCC和CEA水平。
