血清鳞状上皮细胞癌抗原在宫颈癌中的表达及应用

Expression and application of the serum squamous cell carcinoma antigen in the infiltrating cervical cancer

目的通过检测浸润性宫颈癌患者治疗前后血清鳞状上皮细胞癌抗原(SCC-Ag)的表达,结合宫颈癌的临床病理特征探讨其在评估宫颈癌预后及疗效中的作用。方法用ELISA法检测94例[其中30例接受全程同步放化疗(CCRT)]的宫颈癌患者治疗前及治疗后血清中的SCC-Ag水平。结果①血清SCC-Ag的水平与宫颈癌的组织学分型有关,鳞癌阳性率最高(71.4%),腺癌亦有表达(20.0%),总灵敏度为67.0%(63/94);②血清SCC-Ag的水平与宫颈癌肿瘤的直径大小呈正相关性(P<0.05);③血清SCC-Ag≥4.00ng/mL时,与盆腔淋巴结转移有关(P<0.05);④在接受CCRT后,86.7%(26/30)的患者血清SCC-Ag水平降至正常范围;⑤在25例完全缓解的宫颈癌患者中,有96%(24/25)治疗后SCC-Ag水平降至正常范围。结论血清SCC-Ag的表达对宫颈癌的诊断、预后评估和疗效观察有较高的临床价值。

[Objective] To determine the prognostic and therapeutic significance of the pre-and post-treatment serum squamous cell carcinoma antigen（SCC-Ag） levels in patients with cervical cancer.[Methods] 30 of 94 patients were treated with concurrent chemoradiotherapy（CCRT）.The SCC-Ag levels were measured in 94 patients before treatment,in 30 patients during 3 months after treatment,and at the follow-up.[Results] ①The serum levels of SCC-Ag had relation to the histological category of cervical cancer,they were elevated in 71.4%（60/80） patients with squamous carcinoma,and in 20%（1/5） patient with adenocarcinoma.Its sensitivity in detecting the cervical cancer of different histological category was 67%（63/94）.②The content of SCC-Ag was closely related to tumor volume（P 0.05）.③When the pretreatment serum levels of SCC-Ag was over 4 ng/mL,it was associated with the pelvic lymph node status（P 0.05）.④The serum levels of SCC-Ag in 86.7%（26/30） patients were obviously decrease after treatment with concurrent chemoradiotherapy（CCRT）.⑤Among the patients who gained CR with a previously elevated SCC-Ag,the values were normalized in 96%（24/25） after treatment.[Conclusion] Assays of the pre-and post treatment serum SCC-Ag levels are useful for both predicting the prognosis and estimating the clinical response in cervical cancer.