Can initial serum cyfra 21-1, SCC antigen, and TPA levels in squamous cell cervical cancer predict lymph node metastases or prognosis?
OBJECTIVE
The aim of this study was to determine whether lymph node metastases or prognosis can be predicted by initial serum Cyfra 21-1, tissue polypeptide antigen (TPA), and squamous cell carcinoma antigen (SCC-Ag) levels in squamous cell cervical cancer.


METHODS
Pretreatment serum levels of 92 patients were correlated with clinicopathologic parameters and prognostic data. The clinical performance of the tests was evaluated by their receiver operating characteristic curves. The prognostic power of the variables was assessed using Cox regression analysis.


RESULTS
Serum levels of each marker were significantly related to tumor stage, size, and depth of infiltration. The clinical performance of each marker in predicting lymph node metastases or parametrial involvement was poor. In the stepwise Cox regression analysis, regarding patients with early stage cervical cancer (stage Ib/IIa, n = 63), tumor size (P = 0.0005) was the only independent prognostic factor for disease-free interval. Lymph node status (P = 0.0014), tumor size (P = 0.004), and parametrial involvement (P = 0.025) were independent risk factors for survival. Considering all patients with stages Ia through IVb disease, tumor size (P = 0.0001) and TPA level (P = 0. 026) were independent risk factors for disease-free interval, whereas tumor size (P = 0.0001) and parametrial involvement (P = 0. 0002) were risk factors for survival.


CONCLUSIONS
Pretreatment Cyfra 21-1, TPA, and SCC-Ag levels were strongly related to tumor burden, but insufficiently reliable for identifying patients at risk of the presence of lymph node metastases or parametrial involvement. Serum levels of each marker showed no independent prognostic value in early stage cervical cancer.
Gaarenstroom
K N
KN
Department of Gynecology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands.
Kenter
G G
GG
Bonfrer
J M
JM
Korse
C M
CM
Van de Vijver
M J
MJ
Fleuren
G J
GJ
Trimbos
J B
JB
D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D053539:Keratin-19; D007633:Keratins; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D015843:Serpins; D019396:Tissue Polypeptide Antigen / Q000097:blood*; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000473:pathology
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; D015843:Serpins; D019396:Tissue Polypeptide Antigen; C102012:antigen CYFRA21.1; C051072:squamous cell carcinoma-related antigen; D007633:Keratins