title: Combination of squamous cell carcinoma-antigen, carcinoembryonic antigen, and carbohydrate antigen 19-9 predicts positive pelvic lymph nodes and parametrial involvement in early stage squamous cell carcinoma of the uterine cervix.
abstract: OBJECTIVE
  We examined the correlations between the pretreatment values of four tumor markers (squamous cell carcinoma [SCC]-antigen, carcinoembryonic antigen [CEA], carbohydrate antigen [CA]19-9, and CA125) and postsurgical high-risk factors (parametrial involvement and positive pelvic lymph nodes) in women with SCC of the uterine cervix who had International Federation of Gynecology and Obstetrics clinical stage IB and IIA disease and underwent radical hysterectomy.
  
  
  METHODS
  In this retrospective study, we reviewed 291 patients between April 1989 and December 2008. The first 200 subjects, studied between 1989 and 2001, served as the training set, and another 91 subjects, studied between 2002 and 2008, comprised the test set. To evaluate the correlations between pretreatment tumor markers and postsurgical high-risk factors, the χ²-test and logistic regression analysis were used for univariate and multivariate analysis, respectively.
  
  
  RESULTS
  Multivariate analysis with receiver-operator curves showed that the combination of SCC-antigen, CEA, and CA19-9 strongly predicted postsurgical high-risk factors. Analysis of the training set showed that 66.7% (95% confidence interval, 52.6-84.8%) of patients who tested positive for at least two of these three tumor markers had postsurgical high-risk factors. Similar results were obtained with the test set.
  
  
  CONCLUSIONS
  Preoperative levels of SCC-antigen, CEA, and CA19-9 are useful for predicting the status of postsurgical high-risk factors in women with SCC of the uterine cervix who undergo radical hysterectomy.
authors.affiliation: Division of Gynecology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan. shuikeda@ncc.go.jp
authors.forename: Shun-ichi
authors.initials: S
authors.lastname: Ikeda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Onda
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kasamatsu
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Kato
authors.forename: Mitsuya
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sasajima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
mesh_terms: D000951:Antigens, Neoplasm / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D009372:Neoplasms, Connective Tissue / Q000473:pathology / Q000556:secondary; D010386:Pelvic Neoplasms / Q000473:pathology / Q000556:secondary*; D010388:Pelvis; D011379:Prognosis; D012189:Retrospective Studies; D015843:Serpins / Q000097:blood*; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery
chemical_list: D000951:Antigens, Neoplasm; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D015843:Serpins; C051072:squamous cell carcinoma-related antigen