title: Prognostic value of preoperative squamous cell carcinoma antigen level in patients surgically treated for cervical carcinoma.
abstract: 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.
authors.affiliation: Regional Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead, United Kingdom.
authors.forename: B S
authors.initials: BS
authors.lastname: Bolger
authors.forename: M
authors.initials: M
authors.lastname: Dabbas
authors.forename: A
authors.initials: A
authors.lastname: Lopes
authors.forename: J M
authors.initials: JM
authors.lastname: Monaghan
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000556:secondary; D000328:Adult; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D018196:Carcinoma, Adenosquamous / Q000097:blood* / Q000401:mortality / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D015843:Serpins; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015843:Serpins; C051072:squamous cell carcinoma-related antigen