The role of pretreatment squamous cell carcinoma antigen in predicting nodal metastasis in early stage cervical cancer.
OBJECTIVE
To evaluate whether the presence of pelvic lymph node metastasis can be predicted by pretreatment squamous cell carcinoma antigen (SCC-Ag) levels in early stage squamous cervical carcinoma.


METHODS
Between 1994 and 1998, 284 patients with stage Ib and IIa cervical squamous cell carcinoma undergoing radical hysterectomy had preoperative SCC-Ag determination. The correlation between clinicopathological findings on SCC-Ag levels were examined. The Mann-Whitney U test was used to statistically analyze differences between node positive and negative patients. Multiple regression analysis and a multiple logistic model were employed to examine the effect of clinicopathological findings on SCC-Ag levels.


RESULTS
Of the 284 patients, 56 patients were found to have nodal metastasis. Median serum levels and 90% ranges of SCC-Ag were 0.74 microg/l (0.5-7.8) in the 228 nodal negative patients and 4.33 microg/l (0.5-48.5) in the 56 nodal positive patients (p<0.001). Lymph node metastasis and tumor size were found to have a significant impact on SCC-Ag levels. Around 86% of the patients with SCC-Ag levels below 8 microg/l showed no nodal metastasis, while about 65% of the patients with serum levels above 8 microg/l exhibited nodal metastasis. Multivariate analyses confirmed that only lymph node metastasis had a significant impact on the SCC-Ag levels exceeding 8 microg/l.


CONCLUSIONS
For predicting nodal metastasis preoperatively, SCC-Ag levels greater than 8 microg/ l can be considered a high-risk zone for nodal metastasis.
Lin
H
H
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
ChangChien
C C
CC
Huang
E Y
EY
Tseng
C W
CW
Eng
H L
HL
Huang
C C
CC
D000951:Antigens, Neoplasm / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000145:classification / Q000175:diagnosis* / Q000276:immunology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000276:immunology*; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging / Q000379:methods*; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods*; D012044:Regression Analysis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015843:Serpins; D018709:Statistics, Nonparametric; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000145:classification / Q000175:diagnosis* / Q000276:immunology* / Q000601:surgery
D000951:Antigens, Neoplasm; D015843:Serpins; C051072:squamous cell carcinoma-related antigen