SCC-Ag与宫颈癌临床病理特征的相关性及对淋巴结转移的预测价值

Correlations with Clinicopathological Findings and Diagnostic Value for Lymph Node Metastasis of Pretreatment Serum SCC-Ag Levels in Cervical Cancer

目的:探讨鳞状细胞癌抗原(SCC-Ag)与ⅠB1-ⅡB期宫颈鳞癌患者临床病理特征的相关性,尤其是对淋巴结转移的预测价值。方法:选择237例治疗前检测过血清SCC-Ag的ⅠB1-ⅡB期宫颈鳞癌患者,结合临床资料对SCC-Ag与临床病理特征的相关性进行单因素及多因素分析;绘制受试者工作特征(ROC)曲线,确定SCC-Ag对淋巴结转移的预测价值。结果:多因素分析显示大肿块(OR=7.391)、淋巴结转移(OR=2.457)、脉管内癌栓(OR=3.748)、分化良好(OR=1.453)均是影响血清SCC-Ag滴度升高的独立危险因素。ROC曲线显示SCC-Ag水平对淋巴结转移的诊断价值中等。ⅠB1、ⅡA1期的ROC曲线下面积由0.705增加至0.728。结论:治疗前SCC-Ag水平与肿瘤直径、淋巴结状态、有无脉管内癌栓、肿瘤细胞分化程度相关,对淋巴结转移有一定的预测作用,在ⅠB1、ⅡA1期中的诊断价值增加。

Objective：To examinate the correlations between the pretreatment values of SCC-Ag and clinicopathological findings and evaluate whether it can predict the presence of pelvic lymph node metastasis inⅠB1-ⅡB cervical squamous cell carcinoma.Methods：237patients with stageⅠB1-ⅡB cervical squamous cell carcinoma had pretreatment SCC-Ag determination.The correlations between clinicopathological findings and SCC-Ag levels were examined by univariate and multivariate analysis.The receptor performance curve（ROC）of the cases was drawn to decide the predictive value of SCC-Ag in lymph node metastasis.Results：Larger tumor size（OR=7.391）,lymph node metastasis（OR=2.457）,lymphovascular space invasion（OR=3.748）and well dif-ferentiated（OR=1.453）were demonstrated to be independent risk factors for the elevated pretreatment level of SCC-Ag in the multivariate analysis.The diagnostic value for lymph node involvement of SCC-Ag levels was moderate by ROC.The AUC increased from 0.705 to 0.728 in stagesⅠB1andⅡA1.Conclusion：SCC-Ag level was found to correlate with tumor size,lymph node status,with or without lymphovascular space invasion and tumor cell differentiation.And it is useful for predicting lymph node metastasis,the diagnostic value would improve in stagesⅠB1andⅡA1.