title: Clinical implications of elevated pretreatment carcinoembryonic antigen in patients with advanced squamous cell carcinoma of the uterine cervix.
abstract: OBJECTIVE
  The aim of this study was to investigate the prognostic significance of pretreatment levels of carcinoembryonic antigen (CEA) for treatment outcome in comparison with squamous cell carcinoma antigen (SCC) in cervical cancer patients following concurrent chemoradiotherapy (CCRT).
  
  
  METHODS
  A total of 148 patients with stage IB2-IVA squamous cell carcinoma of the uterine cervix who were treated with a full course of CCRT were included for analysis. The pretreatment blood samples of tumor markers were obtained before initiation of CCRT. Values for SCC <2 and CEA <5 ng/ml, respectively, were regarded as normal. Cox's proportional hazards model was performed for risk stratification for disease-free survival (DFS) and cause-specific survival (CSS).
  
  
  RESULTS
  Pretreatment CEA and SCC levels were elevated in 37.2 and 64.2% of the patients, respectively. Positive pelvic lymph node, stage and pretreatment CEA levels >10 ng/ml were three independent prognostic factors for DFS and CSS. The 5-year DFS for the low- and high-CEA groups was 80 and 56%, respectively (p = 0.02, hazard ratio 2.6), whereas the 5-year CSS for the low- and high-CEA groups was 84 and 63%, respectively (p = 0.01, hazard ratio 3.2).
  
  
  CONCLUSIONS
  Despite lower sensitivity, pretreatment CEA levels >10 ng/ml predict a poor outcome in advanced squamous cell carcinoma of the cervix.
authors.affiliation: Department of Radiotherapy and Oncology, Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. vincent1680616@yahoo.com.tw
authors.forename: Shang-Wen
authors.initials: SW
authors.lastname: Chen
authors.forename: Ji-An
authors.initials: JA
authors.lastname: Liang
authors.forename: Yao-Ching
authors.initials: YC
authors.lastname: Hung
authors.forename: Lian-Shung
authors.initials: LS
authors.lastname: Yeh
authors.forename: Wei-Chun
authors.initials: WC
authors.lastname: Chang
authors.forename: Shih-Neng
authors.initials: SN
authors.lastname: Yang
authors.forename: Fang-Jen
authors.initials: FJ
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015843:Serpins / Q000097:blood; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D015843:Serpins; C051072:squamous cell carcinoma-related antigen