Background

Tumor marker screening may be useful to evaluate tumor response and detect tumor recurrence. However, usefulness and cut-off value of squamous-cell carcinoma antigen (SCC-Ag) for recurrence and survival has not yet established in cervical cancer.

Methods

From January 2010 to October 2016, 304 patients with cervical squamous-cell carcinomas with FIGO stage IB-IVA who underwent curative chemoradiotherapy followed by brachytherapy at four institutions were included in this study. Serum SCC-Ag level was measured before treatment, re-measured after completion of treatment, and again at the time of relapse during follow-up. SCC-Ag levels at each measurement point were analyzed using receiver operating characteristic (ROC) curve. Their associations with recurrence-free survival (RFS) and overall survival (OS) were analyzed.

Results

During a median follow-up time of 36.5 months, there were 66 (21.7%) recurrences and 76 (25.0%) deaths. The ROC curve showed optimal Youden indices were 4, 1.5, and 4 ng/mL at pretreatment, treatment, and recurrence, respectively. In patients with SCC-Ag ≥ 4 ng/mL, not SCC-Ag < 4 ng/mL before treatment, post-treatment SCC-Ag level (≥ 1.5 ng/mL vs. < 1.5 ng/mL) showed significant differences in 3-year RFS (65.5% vs. 45.0%, p < 0.001) and OS (78.5% vs. 55.4%, p < 0.001). In 66 recurrent patients, patients with SCC-Ag ≥ 4 ng/mL at recurrence showed a significantly lower OS rate than others (59.5% vs. 33.0%, p = 0.041).

Conclusions

SCC-Ag level after treatment and at recurrence was useful for predicting recurrence and survival only when its pretreatment value was high (≥ 4 ng/mL).

中文翻译：

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血清SCC-Ag水平的系列评估能否确定行放化疗治疗的子宫颈鳞状细胞癌的肿瘤复发率和患者生存率？多机构分析。

背景

肿瘤标志物筛选可能对评估肿瘤反应和检测肿瘤复发有用。然而，宫颈癌中鳞状细胞癌抗原（SCC-Ag）对于复发和生存的有用性和临界值尚未确定。

方法

从2010年1月至2016年10月，本研究纳入了304例FIGO IB-IVA期宫颈鳞状细胞癌患者，这些患者在四个机构进行了根治性放化疗，并进行了近距离放射治疗。在治疗前测量血清SCC-Ag水平，在治疗完成后重新测量，并在随访期间再次测量。使用接收器工作特性（ROC）曲线分析了每个测量点的SCC-Ag水平。分析了它们与无复发生存期（RFS）和总生存期（OS）的关系。

结果

在36.5个月的中位随访时间内，有66例（21.7％）复发，76例（25.0％）死亡。ROC曲线显示，在预处理，治疗和复发时，最佳的尤登指数分别为4、1.5和4 ng / mL。在治疗前SCC-Ag≥4 ng / mL而不是SCC-Ag <4 ng / mL的患者中，治疗后SCC-Ag水平（≥1.5 ng / mL与<1.5 ng / mL）显示出显着差异3年RFS（65.5％vs.45.0％，p  <0.001）和OS（78.5％vs. 55.4％，p  <0.001）。在66例复发患者中，复发时SCC-Ag≥4 ng / mL的患者的OS率显着低于其他患者（59.5％对33.0％，p  = 0.041）。

结论

治疗后和复发时的SCC-Ag水平仅在其预处理值较高（≥4 ng / mL）时才可用于预测复发和生存。