Combination of squamous cell carcinoma antigen immunocomplex and alpha-fetoprotein in mid-and long-term prediction of hepatocellular carcinoma among cirrhotic patients

BACKGROUND The combination of alpha-fetoprotein(AFP)and squamous cell carcinoma antigen immunocomplex(SCCA-IgM)have been proposed for its use in the screening of hepatocellular carcinoma(HCC).Current screening programs for all cirrhotic patients are controversial and a personalized screening is an unmet need in the precision medicine era.AIM To determine the role of the combination of SCCA-IgM and AFP in predicting mid-and long-term appearance of HCC.METHODS Two-hundred and three cirrhotic patients(Child A 74.9%,B 21.2%,C 3.9%)were followed-up prospectively every six months to screen HCC by ultrasound and AFP according to European Association for the Study of the Liver guidelines.The estimation cohort was recruited in Italy(30.5%;62/203)and validation cohort from Spain(69.5%;141/203).Patients underwent to evaluate SCCA-IgM by enzyme-linked immunosorbent assay(Hepa-IC,Xeptagen,Italy)and AFP levels at baseline.Patients were followed-up for 60 mo,being censored at the time of the appearance of HCC.RESULTS There were 10.8%and 23.1%of HCC development at two-and five-years followup.Patients with HCC showed higher levels of SCCA-IgM than those without it(425.72±568.33 AU/mL vs 195.93±188.40 AU/mL,P=0.009)during the fiveyear follow-up.In multivariate analysis,after adjusting by age,sex,aspartate transaminase and Child-Pugh,the following factors were independently associated with HCC:SCCA-IgM[Hazard ratio(HR)=1.001,95%CI:1.000-1.002;P=0.003],AFP(HR=1.028,95%CI:1.009-1.046;P=0.003)and creatinine(HR=1.56495%CI:1.151-2.124;P=0.004).The log-rank test of the combination resulted in 7.488(P=0.024)in estimation cohort and 11.061(P=0.004)in the validation cohort,and a 100%of correctly classified rate identifying a low-risk group in both cohorts in the two-year follow-up.CONCLUSION We have constructed a predictive model based on the combination of SCCA-IgM and AFP that provides a new HCC screening method,which could be followed by tailored HCC surveillance for individual patients,especially for those cirrhotic patients belonging to the subgroup identified as low-risk of HCC development.

Clinical applications of squamous cell carcinoma antigenimmunoglobulins M to monitor chronic hepatitis C

Hepatitis C virus(HCV) is the main cause of chronic liver disease and cirrhosis in Western countries. Over time, the majority of cirrhotic patients develop hepatocellular carcinoma(HCC), one of the most common fatal cancers worldwide- fourth for incidence rate. A high public health priority need is the development of biomarkers to screen for liver disease progression and for early diagnosis of HCC development, particularly in the high risk population represented by HCV-positive patients with cirrhosis. Several studies have shown that serological determination of a novel biomarker, squamous cell carcinoma antigen-immunoglobulins M(SCCA-Ig M), might be useful to identify patients with progressive liver disease. In the initial part of this review we summarize the main clinical studies that have investigated this new circulating biomarker on HCV-infected patients, providing evidence that in chronic hepatitis C SCCA-Ig M may be used to monitor progression of liver disease, and also to assess the virological response to antiviral treatment. In the last part of this review we address other, not less important, clinical applications of this biomarker in hepatology.

High expression of squamous cell carcinoma antigen in poorly differentiated adenocarcinoma of the stomach: A case report

BACKGROUND Squamous cell carcinoma antigen(SCCA)is regarded as a specific indicator of epithelial malignancies and is widely used in the diagnosis of squamous cell carcinoma(SCC).However,the expression of SCCA in gastric adenocarcinoma has not been studied in detail.CASE SUMMARY A 52-year-old man was admitted to our hospital for a 2.5 cm x 2.5 cm ulcer at the antrum-body junction with dull pain and fullness in the upper abdomen for 2 mo.His pre-surgery serological testing results showed 0.51 ng/mL SCCA(reference interval,<1.5 ng/mL)and 9.9 ng/mL carcinoembryonic antigen(reference range,<4.7 ng/mL).He underwent radical distal gastrectomy and Roux-en Y anastomosis and was diagnosed with poorly differentiated mucinous adenocarcinoma(Lauren classification:Diffuse)by pathological examination of the resected lesion.Immunohistochemistry showed that SCCA was highly expressed in the cytoplasm of cancer cells.After surgery,the patient received an S-1 adjuvant chemotherapy regimen for six cycles containing tegafur,gimeracil,and oteracil potassium.He showed no sign of recurrence or metastasis within 24-mo follow-up.CONCLUSION This is a frontal report of SCCA overexpression in poorly differentiated adenocarcinoma of the stomach.

Impact of Preoperative Serum Tumor Markers in Patients with Lung Squamous Cell Carcinoma

Background: Several previous researchers have investigated the prognostic value of serum tumor markers, especially carcinoembryonic antigen (CEA). Only a limited number of studies reported the usefulness of serum tumor markers for lung squamous cell carcinoma (SQ). We aimed to examine the significance of serum tumor markers for lung SQ. Methods: Eighty-five lung SQ patients who underwent surgery and followed more than 5-year were included. The ratios of 5-year survivors to all patients in groups with several clinicopathologic factors, including tumor markers, were compared. We also compared the clinicopathologic factors between central type and peripheral type SQ. Results: The majority of patients were male gender and current/ former smokers. Age, pN status, cytokeratin-19 fragment (CYFRA 21-1), squamous cell carcinoma antigen (SCC), and comorbid interstitial pneumonia (IP) were associated with the ratio of 5-year survivors significantly. When patients were compared based on tumor location, high p-stage and CYFRA 21-1 were related to central type SQ. Conclusion: Both SCC and CYFRA 21-1 appeared to be useful prognostic markers for patients with lung SQ. Furthermore, CYFRA 21-1 was related to central type SQ.

Identification of interleukin-6 (IL-6) and squamous cell carcinoma (SCC) as amniotic fluid-specific markers

Objective: To determine if an amniotic fluid (AF)-specific marker is present and if its concentration changes with the presence of labor. Study Design: Twenty-six healthy women who gave birth to healthy newborns at term during the period from July 2009 to January 2010 were included in the study. Six candidate markers were assessed by commercially available ELISA kits: interleukin (IL)-6, squamous cell carcinoma (SCC) antigen, insulin-like growth factor (IGFBP)-1, osteopontin (OPN), CA125, and sialyl Tn (STN). Results: The AF/maternal serum (MS) measurement based on IL-6 or SCC has proved to be superior to IGFBP-1, CA125, OPN and STN. Women with spontaneous labor at term had significantly higher IL-6 and IGFBP-1 concentrations in AF compared with those without labor. No significant differences were observed in the AF concentrations of SCC, OPN, CA125 and STN between women with labor and those not in labor. Conclusion: Our observation of IL-6 and SCC in AF may open a new area of research to assess their usefulness as biological markers of obstetrical disorders.

Ribonucleotide reductase small subunit M2 promotes the proliferation of esophageal squamous cell carcinoma cells via HuR-mediated mRNA stabilization

Esophageal squamous cell carcinoma(ESCC),a malignancy of the digestive system,is highly prevalent and the primary cause of cancer-related deaths worldwide due to the lack of early diagnostic biomarkers and effective therapeutic targets.Dysregulated ribonucleotide reductase(RNR)expression has been confirmed to be causally linked to tumorigenesis.This study demonstrated that ribonucleotide reductase small subunit M2(RRM2)is significantly upregulated in ESCC tissue and that its expression is negatively correlated with clinical outcomes.Mechanistically,HuR promotes RRM2 mRNA stabilization by binding to the adenine/uridine(AU)-rich elements(AREs)within the 3′UTR,resulting in persistent overexpression of RRM2.Furthermore,bifonazole is identified as an inhibitor of HuR via computational screening and molecular docking analysis.Bifonazole disrupts HuR-ARE interactions by competitively binding to HuR at F65,R97,I103,and R153 residues,resulting in reduced RRM2 expression.Furthermore,bifonazole exhibited antitumor effects on ESCC patient-derived xenograft(PDX)models by decreasing RRM2 expression and the dNTP pool.In summary,this study reveals the interaction network among HuR,RRM2,and bifonazole and demonstrated that bifonazole is a potential therapeutic compound for ESCC through inhibition of the HuR/RRM2 axis.

血清SCCAg、NGAL及CA724在不同病理特征子宫内膜癌中的表达意义及其与病情严重程度、淋巴结节转移的相关性分析

目的分析血清鳞状细胞癌抗原(SCCAg)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及糖类抗原724(CA724)在不同病理特征子宫内膜癌中的表达意义及其与病情严重程度、淋巴结节转移的相关性。方法回顾性选取2020年1月至2022年12月江苏省肿瘤医院接诊的150例子宫内膜癌患者作为研究组,并选择同期健康体检的147名健康女性作为对照组。检测两组研究对象的血清SCCAg、NGAL及CA724的水平,分析不同TNM分期(Ⅰ~Ⅱ期102例,Ⅲ~Ⅳ期48例)、分化程度(高分化105例,中低分化45例)、浸润肌层程度(<1/2为103例,≥1/2为47例)的子宫内膜癌患者血清SCCAg、NGAL及CA724水平的差异性。采用Spearman相关性分析血清SCCAg、NGAL及CA724与子宫内膜癌TNM分期、分化程度的关系。通过受试者工作特征(ROC)曲线下面积(AUC)评价血清SCCAg、NGAL联合CA724对子宫内膜癌患者发生淋巴结节转移的预测效能。结果研究组的血清SCCAg、NGAL及CA724水平分别为(1.75±0.19)μg/L、(296.94±20.44)ng/mL、(19.72±4.05)U/mL,均高于对照组[(1.13±0.15)μg/L、(147.57±15.63)ng/mL、(5.22±1.08)U/mL],差异均有统计学意义(P<0.05)。Ⅲ~Ⅳ期患者的血清SCCAg、NGAL及CA724水平均高于Ⅰ~Ⅱ期,中低分化患者的血清SCCAg、NGAL及CA724水平均高于高分化,子宫肌层浸润≥1/2患者的血清SCCAg、NGAL及CA724水平均高于子宫肌层浸润<1/2,差异均有统计学意义(P<0.05)。经Spearman相关性分析,血清SCCAg、NGAL及CA724水平与子宫内膜癌TNM分期呈正相关(r=0.612、0.457、0.506,P<0.05),与分化程度呈负相关(r=-0.364、-0.412、-0.569,P<0.05)。在150例子宫内膜癌患者中,发生淋巴结节转移26例,占17.33%。经ROC曲线分析,血清SCCAg、NGAL联合CA724预测子宫内膜癌患者发生淋巴结节转移的敏感度为63.12%,特异度为88.75%,AUC为0.889。结论血清SCCAg、NGAL及CA724在不同TNM分期、分化程度、浸润肌层程度的子宫内膜癌患者中差异明显,均与病情严重程度有关,联合预测淋巴结节转移的效能较好。

宫颈癌患者血清SCC-Ag、NLR水平与临床病理特征及预后关系

目的:探讨宫颈癌患者血清鳞状细胞癌抗原(SCC-Ag)、中性粒细胞与淋巴细胞比值(NLR)与临床病理特征及预后关系。方法:纳入2018年1月-2023年1月本院收治的108例宫颈癌患者为宫颈癌组,宫颈上皮内瘤病变(CIN)患者108例为CIN组,健康体检健康女性108例为对照组。比较3组血清SCC-Ag、NLR水平,分析宫颈癌组血清SCC-Ag、NLR水平与临床病理特征及与预后关系。结果:血清SCC-Ag、NLR水平,宫颈癌组(7.35±1.76、4.65±1.06)、CIN组(2.06±0.53、3.41±0.89)、对照组(0.54±0.12、1.53±0.34)依次降低(P<0.05)。宫颈癌患者血清SCC-Ag、NLR水平与病理类型、FIGO分期、病理分级、肌层浸润深度和盆腔淋巴结转移有关(P<0.05)。Kaplan-Meier显示,SCC-Ag、NLR高表达组总生存率、无病生存率均低于SCC-Ag、NLR低表达组,SCC-Ag高表达+NLR高表达组总生存率、无病生存率最低(均P<0.05)。结论:宫颈癌患者血清SCC-Ag、NLR水平与病理类型、FIGO分期、病理分级和肌层浸润深度等有关,且SCC-Ag、NLR水平越高患者预后越差。

Cytokeratin 19 fragment antigen 21-1 as an independent predictor for definitive chemoradiotherapy sensitivity in esophageal squamous cell carcinoma

Background Patients with esophageal squamous cell carcinoma （ESCC） undergoing definitive chemoradiotherapy （CRT） seem to have a disparity in therapeutic response. The identification of CRT sensitivity-related clinicopathological factors would be helpful for selecting patients most likely to benefit from CRT. Cytokeratin 19 fragment antigen 21-1 （CYFRA21-1） and carcinoembryonic antigen （CEA） have been reported as useful tumor markers for esophageal cancer. The aim of this study was to examine the predictive value of CYFRA21-1 in comparison with CEA and other clinicopathological factors in patients with ESCC treated with definitive CRT. Methods Pretreatment serum CYFRA21-1 and CEA levels were measured by immunoradiometric assays. The relationships between pretreatment clinicopathological factors and the efficacy of CRT were analyzed. Overall survival （OS） was estimated by univariate and multivariate analysis. Results The results from a univariate analysis indicated that the efficacy of CRT was significantly associated with the serum levels of CYFRA21-1 and CEA before treatment （P=0.001 and P=0.023, respectively）. It also indicated that the efficacy of CRT was significantly associated with the pretreatment tumor location （P=-0.041）. By Logistic regression analysis, the independent predictive factor associated with efficacy of CRT was CYFRA21-1 （P=0.002）. The OS of the patients with high CYFRA 21-1 levels was worse than that of those with low CYFRA21-1 levels （P=0.001）. In multivariate analysis, a low level of CYFRA21-1 was the most significant independent predictor of good OS （P=0.007）. Conclusions CEA and tumor location may be useful in predicting the sensitivity of ESCC to CRT. CYFRA21-1 may be an independent predictor for definitive CRT sensitivity in ESCC.

血清肿瘤标志物联合检测对肺癌患者术后复发的预测价值

目的 探讨血清肿瘤标志物[癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌相关抗原(SCC-Ag)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、胃泌素释放肽前体(ProGRP)]联合检测对肺癌患者术后复发的预测价值。方法 选取110例肺癌患者和110例健康体检者,分别作为观察组和健康组,比较两组受试者、术前和术后1年肺癌患者、复发与未复发肺癌患者术后1年血清CEA、NSE、SCC-Ag、CYFRA21-1、ProGRP水平。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估血清CEA、NSE、SCC-Ag、CYFRA21-1、ProGRP单独及联合检测对肺癌患者术后复发的预测价值。结果 观察组患者血清CEA、NSE、SCC-Ag、CYFRA21-1、ProGRP水平均明显高于健康组,差异均有统计学意义(P﹤0.01)。术后1年,肺癌患者血清CEA、NSE、SCC-Ag、CYFRA21-1、ProGRP水平均明显低于术前,差异均有统计学意义(P﹤0.01)。随访1年,110肺癌手术患者中,复发30例,未复发80例,未复发肺癌患者术后1年血清CEA、NSE、SCC-Ag、CYFRA21-1、ProGRP水平均明显低于复发患者,差异均有统计学意义(P﹤0.01)。ROC曲线显示,血清CEA、NSE、SCC-Ag、CYFRA21-1、ProGRP联合检测预测肺癌患者术后复发的AUC为0.930(95%CI:0.875~0.985),灵敏度为85.00%,特异度为93.75%,均高于各指标单独检测。结论 肺癌患者血清CEA、NSE、SCC-Ag、CYFRA21-1、ProGRP水平较高,上述指标联合检测预测肺癌患者术后复发的效能较高。

PD⁃1抑制剂联合全身化疗治疗复发转移性宫颈癌的临床效果观察

目的探讨程序性细胞死亡受体-1(PD-1)抑制剂(卡瑞利珠单抗)免疫治疗联合全身化疗治疗复发转移性宫颈癌的临床效果。方法选择2019年2月—2021年6月定州市人民医院收治的复发转移性宫颈癌64例,依据随机数字表法分为研究组和对照组各32例。对照组给予紫杉醇联合顺铂全身化疗方案,研究组给予全身化疗方案+PD-1卡瑞利珠单抗免疫治疗。比较2组临床疗效,分析治疗前及治疗3个周期后鳞状细胞癌抗原(SCC)、外周血淋巴细胞/单核细胞(LMR)及血小板/淋巴细胞(PLR)指标水平及Kamofsky评分变化,并观察治疗期间毒性作用发生情况及随访期间患者总生存期。结果研究组总有效率、疾病控制率分别为93.75%(30/32)、96.88%(31/32),高于对照组的68.75%(22/32)、75.00%(24/32),差异有统计学意义(P<0.05)。治疗3个周期后,2组血清SCC、PLR水平较治疗前降低,LMR较治疗前升高,且研究组改善程度优于对照组(P<0.05)。治疗后,2组Kamofsky评分均较治疗前升高,且研究组高于对照组(P<0.05)。治疗后研究组1、2年生存率及总生存期高于或长于对照组(P<0.05)。2组毒性作用多数为1~2级。研究组血小板下降和转氨酶升高比例分别为37.50%(12/32)和28.12%(9/32),高于对照组的18.75%(6/32)和9.38%(3/32),差异有统计学意义(P<0.05);2组贫血、白细胞下降、恶心、腹泻、乏力等毒性作用发生率比较差异无统计学意义(P>0.05);研究组中发生反应性毛细血管增生症、甲状腺功能减退、皮疹、带状疱疹、过敏等经对症处理后症状消失。结论PD-1抑制剂联合全身化疗治疗复发转移性宫颈癌提高了临床效果、生存质量及生存率,延长生存期,改善了机体的炎症免疫反应状态,毒性作用较少,患者耐受性好。

The serum squamous cell carcinoma antigen level in inverted sinonasal papilloma and nasal polyps patients

Objective:To clarify whether the serum squamous cell carcinoma antigen(SCCA)levels of patients with inverted papilloma(IP)are different from patients with nasal polyps(NP)and rhinitis.Materials and methods:Serum SCCA levels were measured in 30 patients with IP and 30 patients with NP at one day before surgery and seven days after surgery and measured in 28 patients with rhinitis.Results:Elevated serum SCCA levels(>1.5 ng/ml)were found in 80.0%of patients in the IP group,6.7%of patients in the NP group and 14.3%of patients in the rhinitis group,which was a significant difference.The medians of serum SCCA levels in the IP,NP and rhinitis groups were 3.9,0.8 and 1.1 ng/ml,respectively,which was a significant difference.The SCCA level in IP group was not significantly correlated according to Krouse Staging.There was a significant difference in serum SCCA levels between the pre-and postoperative stages in the IP group,at 3.9 and 0.8 ng/ml,respectively,while in the NP group the levels were 0.8 and 1.0 ng/ml,not significantly different.With regard to the IP diagnosis in the IP and NP group based on the SCCA level(>1.5 ng/ml),sensitivity and specificity was 80.0%and 93.3%,respectively.Conclusions:The serum SCCA level in patients with IP was elevated and then it decreased after surgery.This was different from NP and rhinitis patients who mostly had normal levels,which did not change.

宫颈癌患者血清微小RNA-195、双皮质素样激酶1、鳞状细胞癌抗原表达水平与临床病理特征及预后相关性研究

目的:探讨宫颈癌患者血清微小RNA-195(miR-195)、双皮质素样激酶1(DCLK1)、鳞状细胞癌抗原(SCC-Ag)水平与临床病理特征及预后的相关性。方法:选取宫颈癌患者72例为观察组,同期体检健康女性60例为对照组,比较两组血清miR-195、DCLK1、SCC-Ag表达水平。采用Spearman法分析宫颈癌患者血清miR-195、DCLK1、SCC-Ag与临床病理特征的相关性,随访3年,记录患者生存情况。采用Cox回归模型分析宫颈癌患者预后的影响因素。结果:观察组血清DCLK1、SCC-Ag水平较对照组升高,miR-195水平较对照组下降(均P<0.05)。血清miR-195水平与淋巴结转移、国际妇产科联盟(FIGO)分期、肿瘤分化程度呈负相关,DCLK1水平与FIGO分期、肿瘤分化程度呈正相关,SCC-Ag水平与肿瘤分化程度、肿瘤直径呈正相关(均P<0.05)。miR-195高表达患者3年生存率高于低表达患者,DCLK1、SCC-Ag高表达患者3年生存率低于低表达患者(均P<0.05)。FIGO分期、分化程度、淋巴结转移、肿瘤直径及血清miR-195、DCLK1、SCC-Ag水平是宫颈癌患者预后的独立影响因素(均P<0.05)。结论:宫颈癌患者血清DCLK1、SCC-Ag水平升高,miR-195水平降低,三者与临床病理特征和预后有关,是宫颈癌患者预后的独立影响因素。

术后血清MMP-2、SCCA1表达水平对鼻腔鼻窦内翻性乳头状瘤术后复发的预测价值

目的探讨术后血清基质金属蛋白酶-2(MMP-2)、鳞状细胞癌抗原1(SCCA1)表达水平对鼻腔鼻窦内翻性乳头状瘤(SNIP)患者术后复发的预测价值。方法回顾性分析手术治疗的SNIP患者65例,根据术后2年内复发情况,将其分为复发组(n=12)和未复发组(n=53)。Elisa法检测手术前后血清MMP-2、SCCA1表达水平。收录临床资料,包括性别、年龄、饮酒史、吸烟史、肿瘤部位、手术方式、术后有无应用5-氟尿嘧啶(5-Fluorouracil,5-FU)、Krouse分期及有无糖尿病、高血压;Logistic回归分析影响SNIP患者术后复发的危险因素;ROC曲线分析术后血清MMP-2、SCCA1表达水平对SNIP患者术后复发的预测价值。结果术后,2组血清MMP-2、SCCA1表达水平均较术前降低(P<0.05),但复发组血清MMP-2、SCCA1表达水平均高于未复发组(P<0.05)。Logistic回归分析显示,有吸烟史、术后未应用5-FU、Krouse分期为T3~T4期、术后血清MMP-2表达水平、SCCA1表达水平是影响SNIP患者术后复发的危险因素(P<0.05)。ROC曲线分析显示,术后血清MMP-2、SCCA1表达水平单独及二者联合预测SNIP患者术后复发的曲线下面积(AUC)分别为0.786、0.800、0.836,敏感度分别为83.33%、75.00%、91.67%,特异度分别为71.70%、79.25%、75.47%。结论术后血清MMP-2、SCCA1表达水平可作为预测SNIP患者术后复发的辅助指标,且二者联合预测的效果更佳。

宫颈癌患者治疗前联合检测血清CYFRA21-1和SCCAg的临床意义

背景与目的:细胞角蛋白19片段抗原21-1(cytokeratin 19 fragment antigen 21-1,CYFRA21-1)可用于细胞角蛋白19片段的定量检测,可作为多种恶性肿瘤的标记物。本研究旨在探讨宫颈癌患者治疗前血清CYFRA21-1和鳞状细胞癌抗原(squamous cell carcinoma antigen,SCCAg)联合检测对宫颈癌诊断的意义及其与临床病理特征的相关性。方法:对100例宫颈癌患者行治疗前血清CYFRA21-1及SCCAg检测,以20例健康妇女为对照,分析其作为诊断参考的特异性和敏感性,并对两者与宫颈癌临床病理特征的相关性进行单因素和多因素分析。结果:CYFRA21-1、SCCAg用于宫颈癌诊断的特异性均为100%。CYFRA21-1、SCCAg升高用于治疗前诊断的敏感性分别为36.0%和47.0%,两者差异无统计学意义(P<0.05)。两者联合检测的敏感性达到60.0%,与CYFRA21-1单一指标相比,其差异有统计学意义(P<0.05)。单因素分析示CYFRA21-1升高与FIGO分期、肿瘤大小相关;SCCAg升高与病理类型、肿瘤大小、宫颈深肌层浸润及盆腔淋巴结转移相关。多因素分析未发现与CYFRA21-1升高显著相关的临床病理因素;与SCCAg升高显著相关的因素为宫颈深肌层浸润和盆腔淋巴结转移。SCCAg升高用于预测盆腔淋巴结转移和宫颈深肌层浸润的敏感性均显著高于CYFRA21-1(75.0%vs.29.2%,P=0.001;55.8%vs.26.9%,P=0.024),联合检测CYFRA21-1对提高SCCAg预测盆腔淋巴结转移和宫颈深肌层浸润的敏感度其差异无统计学意义(79.2%vs.75.0%,P>0.05;63.5%vs.55.8%,P>0.05)。结论:CYFRA21-1对预测盆腔淋巴结转移、宫颈深肌层浸润的价值不及SCCAg。对于宫颈鳞癌患者,SCCAg是首选的肿瘤标志物。

胃泌素释放肽前体、鳞状细胞癌抗原在非小细胞肺癌中的表达及临床意义

目的探讨胃泌素释放肽前体(ProGRP)、鳞状细胞癌抗原(SCCA)在非小细胞肺癌(NSCLC)中的表达及临床意义。方法选取122例NSCLC患者和93例健康体检者,分别作为观察组和对照组。采用化学发光法检测两组受试者血清ProGRP、SCCA水平,比较不同组织学类型NSCLC患者ProGRP、SCCA的水平和阳性表达率,比较两组受试者和不同临床特征NSCLC患者的ProGRP、SCCA阳性表达率。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析ProGRP、SCCA单独及联合检测对NSCLC的诊断价值。结果鳞状细胞癌患者的血清SCCA水平高于腺癌及大细胞癌患者,差异均有统计学意义(P﹤0.05)。鳞状细胞癌患者SCCA的阳性表达率高于腺癌患者,差异有统计学意义(P﹤0.05)。观察组患者ProGRP、SCCA的阳性表达率分别为90.98%、78.69%,分别明显高于对照组的8.60%、6.45%,差异均有统计学意义(P﹤0.01)。有淋巴结转移NSCLC患者ProGRP、SCCA的阳性表达率均明显高于无淋巴结转移患者(P﹤0.01)。ROC曲线显示,ProGRP联合SCCA检测诊断NSCLC的AUC为0.797(95%CI:0.714~0.880),灵敏度为90.59%,特异度为89.25%,均高于二者单独检测。结论ProGRP、SCCA在NSCLC患者中阳性表达率均较高,且其表达与淋巴结转移有关,二者联合检测对NSCLC具有较高的诊断价值。

血清SCCAg及CA125在诊断宫颈鳞癌及评价预后中作用的研究

目的:探讨血清SCCAg及CA125用于宫颈鳞癌诊断、手术治疗及预后的价值。方法:选取ⅠA2～ⅡA期宫颈鳞状细胞癌为研究组,20例CIN及20例慢性宫颈炎分别为对照组1和对照组2。采用固相夹心法酶联免疫吸附实验(ELISA)检测血清SCCAg的数值,采用化学发光免疫分析法(CLIA)检测血清CA125数值。比较分析血清SCCAg及CA125与宫颈鳞癌临床病理特征、手术疗效及预后的关系。结果:宫颈鳞癌组术前血清SCCAg及CA125水平均高于慢性宫颈炎组,差异均具有统计学意义(P<0.01)。宫颈鳞癌组术前SCCAg水平高于CIN组,差异有统计学意义(P<0.001);宫颈鳞癌组术前CA125水平与CIN组的差异无统计学意义(P=0.049,P>0.0167)。血清SCCAg、CA125诊断宫颈鳞癌的临界值分别为1.03ng/ml、8.16U/ml。血清SCCAg、CA125及两项联合诊断宫颈癌的ROC曲线下面积分别为0.954、0.718、0.960,两项联合后诊断性能无明显增加。宫颈鳞癌术前血清SCCAg随临床分期增加具有线性增加的趋势。脉管有否癌栓、盆腔淋巴结有否转移也与术前血清SCCA水平有关,差异有统计学意义(P=0.011,P=0.043)。宫颈鳞癌组手术治疗后的血清SCCAg及CA125水平均有逐渐降低趋势,差异有统计学意义(P均<0.001)。结论:血清SCCAg对宫颈鳞癌有较高的诊断价值,可考虑作为诊断及手术疗效评估指标之一,有助于初步判断脉管及盆腔淋巴结转移。血清CA125对于宫颈鳞癌诊断、手术评估及随访的价值均低于SCCAg,与SCCAg联合不能增加诊断的敏感度和特异度。

血清HE4和SCCAg与子宫内膜癌生物学行为的关系

目的：探讨人附睾分泌蛋白4（HE4）和鳞状细胞癌抗原（SCCAg）在子宫内膜癌的表达及两者与子宫内膜癌生物学行为的关系。方法利用酶联免疫吸附试验检测85例子宫内膜癌患者、30例子宫内膜非典型增生患者及30名健康女性（对照组）血清HE4和SCCAg含量，并对比分析两者对子宫内膜癌的临床价值。结果子宫内膜癌组血清HE4和SCCAg水平分别为（199．6±31．2）pmol/L、0．98（0．15～4．85）μg/L，明显高于子宫内膜非典型增生组[（91．6±16．8）pmol/L、0．18（0．02～1．41）μg/L，P均＜0．05]和对照组[（82．5±9．7）pmol/L、0．13（0．03～1．32）μg/L，P均＜0．05]；HE4和SCCAg对子宫内膜癌诊断的敏感性分别为63．5％、14．1％，特异性为96．7％、100．0％；血清HE4和SCCAg水平及阳性率均随临床分期升高逐渐上升，两者在子宫内膜癌晚期的阳性率（HE4：Ⅲ期90．0％、Ⅳ期100．0％；SCCAg：Ⅲ期30．0％、Ⅳ期25．0％）明显高于早期（Ⅰ期分别为61．1％和5．6％，P均＜0．05）；在不同的临床病理因素中，非子宫内膜样腺癌HE4阳性率达92．0％，明显高于子宫内膜样腺癌（51．7，P＜0．05），HE4在子宫内膜癌的表达与肿瘤大小、病理类型、肿瘤侵润肌层深度及肿瘤转移均有关（P均＜0．05）；而SCCAg在子宫内膜癌的表达仅与肿瘤转移有关（P＜0．01）。结论血清HE4检测对子宫内膜癌的早期诊断及鉴别诊断有一定的临床应用价值，可作为子宫内膜癌病程监测的可靠指标。而SCCAg单独作为子宫内膜癌诊断指标尚无太大意义，仅在病程监测及判断肿瘤转移上有一定价值。

基于核磁共振和鳞状细胞癌抗原预测早期宫颈鳞癌辅助放疗的模型

目的建立一个基于核磁共振和鳞状细胞癌抗原(SCCA)模型,预测早期宫颈鳞癌是否需要术后辅助放疗。方法收集2018—2021年医院收治的67例早期宫颈鳞癌(ⅠB1、ⅠB2、ⅡA1)患者的临床资料,回顾性分析病灶大小、浸润深度、组织分化程度、年龄、SCCA、表观弥散系数(ADC)值、人乳头瘤病毒(HPV)亚型与术后辅助放疗的关系。通过单因素及多因素分析,筛选出影响术后辅助放疗的独立危险因素。应用受试者工作特征(ROC)曲线求得独立危险因素的截断值,进一步构建预测模型。结果单因素分析后发现,病灶大小(P<0.001)、浸润深度(P=0.001)、组织分化程度(P=0.002)、SCCA(P<0.001)、ADC值(P<0.001)影响术后辅助放疗,二元logistic回归多因素分析后发现,病灶大小(OR=1.201,P=0.021)、SCCA(OR=1.608,P=0.033)、ADC值(OR=0.013,P=0.043)是影响辅助放疗的独立危险因素。利用ROC求得截断值分别为:SCCA=4.84μg·L^(-1),病灶=27 mm,ADC=0.907×10^(-3)mm^(2)·s^(-1)。当同时满足任意2个指标时,术后辅助放疗的比率达94.7%以上。结论肿瘤≥27 mm、ADC值≤0.907×10^(-3)mm^(2)·s^(-1)、SCCA≥4.84μg·L^(-1)可以作为判断辅助放疗的指标,若同时满足任意2个指标,辅助放疗的可能性明显增加,此时应慎重考虑治疗方式,尽量避免根治性手术及辅助放疗双重治疗模式带来的严重并发症的发生。

紫杉醇联合卡铂化疗同步放疗对中晚期宫颈癌的疗效及对SCCAg、CYFRA21-1抗原的影响

目的探究紫杉醇与卡铂联合化疗同步放疗对中晚期宫颈癌的临床疗效及对鳞状上皮癌抗原(squamous cell carcinoma antigen,SCCAg)和角质蛋白19片段抗原21-1(CYFRA21-1)的影响。方法选取2011年2月-2013年2月青岛市市立医院收治的中晚期宫颈癌患者62例,将入选患者按治疗方式分为对照组和治疗组,每组各31例。对照组给予单纯放疗,观察组在放疗基础上行同步化疗。对比两组临床疗效、SCCAg和CYFRA21-1含量变化、不良反应发生率和预后。结果两组在年龄、病理学分类、FIGO分期及是否绝经方面差异无统计学意义。治疗后对照组总有效率为54.84%(17/31),观察组为83.87%(26/31),差异有统计学意义(P=0.013)。治疗前对照组和观察组SCCAg分别为(2.04±0.41)μg/ml和(2.13±0.23)μg/ml,CYFRA21-1分别为(2.89±0.67)μg/ml和(3.01±0.42)μg/ml,差异均无统计学意义。治疗后两组SCCAg[(1.46±0.34)μg/ml vs(0.99±0.24)μg/ml]、CYFRA21-1[(1.63±0.37)μg/ml vs(1.02±0.31)μg/ml]均低于治疗前(P均<0.05),且观察组均低于对照组(P均<0.05);对照组和观察组不良反应发生率分别为80.65%(25/31)、35.48%(11/31)(P<0.05);随访60个月后,对照组生存率为3.23%(1/31),观察组生存率为22.58%(7/31),差异有统计学意义(P=0.014)。结论紫杉醇联合卡铂化疗同步放疗对中晚期宫颈癌患者疗效明显,可降低SCCAg、CYFRA21-1表达水平,安全性好。