title: The role of pretreatment squamous cell carcinoma antigen in predicting nodal metastasis in early stage cervical cancer.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: H
authors.initials: H
authors.lastname: Lin
authors.forename: C C
authors.initials: CC
authors.lastname: ChangChien
authors.forename: E Y
authors.initials: EY
authors.lastname: Huang
authors.forename: C W
authors.initials: CW
authors.lastname: Tseng
authors.forename: H L
authors.initials: HL
authors.lastname: Eng
authors.forename: C C
authors.initials: CC
authors.lastname: Huang
mesh_terms: 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
chemical_list: D000951:Antigens, Neoplasm; D015843:Serpins; C051072:squamous cell carcinoma-related antigen