Serum level of squamous cell carcinoma antigen and tumor size are useful to identify preoperatively patients at high risk of cervical cancer.
BACKGROUND
The benefit of postoperative adjuvant therapy for patients with cervical cancer is uncertain, and moreover, may increase morbidity. In this study, patient age, clinical stage of the cancer, tumor size, and levels of serum squamous cell carcinoma cell antigen and carcinoembryonic antigen were studied in patients with Stage Ib and IIa squamous cell carcinoma of the uterine cervix to determine if these parameters can be used, before the surgical intervention, to distinguish patients who require postoperative adjuvant therapy from those who do not.


METHODS
Ninety-nine patients were studied. After surgery, patients were classified either as high risk or low risk according to the results of histopathologic findings. The age of the patient was noted, and FIGO stage, squamous cell carcinoma antigen, carcinoembryonic antigen, and clinical tumor size were determined. A univariate analysis and then a stepwise logistic regression procedure were performed to select significant clinical predictors from among the five variables mentioned above. Any selected predictors were further analyzed by the receiver operator characteristic curve.


RESULTS
Serum squamous cell carcinoma antigen and clinical tumor size measured by colposcopic examination were significant clinical predictors of the treatment strategy postoperatively. From the receiver operator characteristic curve, a sensitivity of 84.2%, a specificity of 91.8%, a positive predictive value of 84.5% were attained.


CONCLUSIONS
Serum squamous cell carcinoma antigen assays and clinical tumor size estimated by colposcopic examination are helpful in identifying patients who require postoperative adjunctive therapy.
Chou
C Y
CY
Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan, Taiwan 704, Republic of China.
Wang
S T
ST
Kuo
H C
HC
Tzeng
C C
CC
Yao
B L
BL
D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D003127:Colposcopy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D015843:Serpins; D002583:Uterine Cervical Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery*
D000951:Antigens, Neoplasm; D002272:Carcinoembryonic Antigen; D015843:Serpins; C051072:squamous cell carcinoma-related antigen