THE VALUE OF PREOPERATIVE SQUAMOUS CELL CARCINOMA ANTIGEN IN PREDICTING NODAL METASTASIS IN EARLY STAGE CERVICAL CANCER

PURPOSE: To investigate the contribution to recurrence detection and survival of serum squamous cell carcinoma antigen (SCC-ag) analysis in the follow-up of early-stage cervical cancer patients. PATIENTS AND METHODS: Follow-up data were evaluated in patients with early-stage squamous cell cervical cancer treated by radical hysterectomy and pelvic lymphadenectomy with or without radiotherapy. Routine serum SCC-ag determination was performed at each follow-up visit. RESULTS: Recurrent disease occurred in 35 (16%) of 225 patients and was preceded or accompanied by serum SCC-ag elevation 26 times (sensitivity, 74%). In five (14%) of these 35 patients, elevated serum SCC-ag was the first measured clinical indicator. Desite salvage therapy, all five patients died of disease. In the other 31 patients (21 with serum SCC-ag elevation), either symptoms and/or positive signs led to recurrence detection. Median survival time after recurrence was worse (9 months; range, 2 to 112+) for patients with an elevated serum SCC-ag value at recurrence in comparison with patients with normal serum SCC-ag values (20 months; range, 4 to 96; P < .01). In 23 of the 190 patients without recurrences, serum SCC-ag values became falsely elevated. In 16 of these 23 patients, the repeat sample after 6 weeks showed a normal SCC-ag, and in seven patients benign (especially skin) disorders were found. CONCLUSION: Serum SCC-ag analysis results in earlier recurrence detection in a small proportion (14%) of patients but did not contribute to better survival. As long as treatment possibilities for recurrent cervical cancer patients are not improved, serum SCC-ag analysis should not be carried out in routine follow-up.

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Prognostic value of the number of the metastatic lymph nodes in locally early-stage cervical cancer: squamous cell carcinoma versus non-squamous cell carcinoma

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-021-06030-w ◽

2021 ◽

Author(s):

Koray Aslan ◽

Ali Haberal ◽

Hüseyin Akıllı ◽

Mehmet Mutlu Meydanli ◽

Ali Ayhan

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Squamous Cell ◽

Prognostic Value ◽

Early Stage ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph ◽

Early Stage Cervical Cancer

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Increased expression level of squamous cell carcinoma antigen 2 and 1 ratio is associated with poor prognosis in early-stage uterine cervical cancer

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2006.00663.x ◽

2007 ◽

Vol 17 (1) ◽

pp. 174-181 ◽

Cited By ~ 25

Author(s):

K.-F. Hsu ◽

S.-C. Huang ◽

A.-L. Shiau ◽

Y.-M. Cheng ◽

M.-R. Shen ◽

...

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Messenger Rna ◽

Early Stage ◽

Quantitative Polymerase Chain Reaction ◽

Disease Free Survival ◽

Uterine Cervical Cancer ◽

Squamous Cell Carcinoma Antigen

Squamous cell carcinoma antigen (SCCA) is a tumor marker for patients with squamous cell carcinoma of uterine cervix, lung, and esophagus. It was encoded by two highly homologous genes, SCCA1 and SCCA2. However, the relevance of SCCA genes to squamous cell carcinogenesis and patient outcome remains far from clear. In this study, by using laser microdissection and real-time quantitative polymerase chain reaction procedures, the messenger RNA (mRNA) expression of the SCCA1 and SCCA2 genes in normal, dysplastic, and malignant squamous epithelia from uterine cervical tissues were analyzed and correlated with outcome of cancer patients. We found that the SCCA2/A1 mRNA ratios were progressively increased from normal, dysplastic, to cancer cells, and the mean ratio was significantly higher in cancer tissues than that in normal epithelium (P= 0.02). The SCCA2/A1 mRNA ratios were not significantly associated with types of human papillomavirus infection (P > 0.05). High SCCA2/SCCA1 mRNA ratios (ratio >1) were an independent predictor of disease recurrence (relative risk: 3.58; P= 0.003). Of the 38 patients with cervical cancer, 12 patients with high SCCA2/SCCA1 mRNA ratios had a significant lower 2-year disease-free survival of only 50%, while it was 92% in those with low SCCA2/SCCA1 mRNA ratios (P < 0.001). In conclusion, our study indicated that the ratios of SCCA2 to SCCA1 RNA were increased during the process of cervical carcinogenesis, and patients with elevated SCCA2/A1 ratio carried a higher risk for recurrence in early-stage uterine cervical cancer.

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The Value of Squamous Cell Carcinoma Antigen as a Predictor of Nodal Metastasis in Cervical Cancer

Gynecologic Oncology ◽

10.1006/gyno.1998.4939 ◽

1998 ◽

Vol 68 (3) ◽

pp. 263-266 ◽

Cited By ~ 37

Author(s):

Nobuhiro Takeshima ◽

Yasuo Hirai ◽

Katsuyoshi Katase ◽

Kenji Yano ◽

Kazuhiro Yamauchi ◽

...

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Nodal Metastasis ◽

Squamous Cell Carcinoma Antigen

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The value of squamous cell carcinoma antigen (SCCa) to determine the lymph nodal metastasis in cervical cancer: A meta-analysis and literature review

PLoS ONE ◽

10.1371/journal.pone.0186165 ◽

2017 ◽

Vol 12 (12) ◽

pp. e0186165 ◽

Cited By ~ 14

Author(s):

Ziqi Zhou ◽

Wenbo Li ◽

Fuquan Zhang ◽

Ke Hu

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Literature Review ◽

Cell Carcinoma ◽

Squamous Cell ◽

Meta Analysis ◽

Nodal Metastasis ◽

Squamous Cell Carcinoma Antigen ◽

Lymph Nodal Metastasis

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Preoperative Serum Squamous Cell Carcinoma Antigen Levels in Clinical Decision Making for Patients With Early-Stage Cervical Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2005.02.123 ◽

2005 ◽

Vol 23 (7) ◽

pp. 1455-1462 ◽

Cited By ~ 42

Author(s):

Nathalie Reesink-Peters ◽

Jacobus van der Velden ◽

Klaske A. ten Hoor ◽

H. Marike Boezen ◽

Elisabeth G.E. de Vries ◽

...

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Squamous Cell ◽

Adjuvant Radiotherapy ◽

Early Stage ◽

Figo Stage ◽

Clinical Parameters ◽

Squamous Cell Carcinoma Antigen ◽

Preoperative Serum ◽

Early Stage Cervical Cancer

PurposeTo prevent morbidity associated with double modality treatment, early-stage cervical cancer patients should only be offered surgery when there is a low likelihood for adjuvant radiotherapy. We analyzed whether serum squamous cell carcinoma antigen (SCC-ag) analysis allows better preoperative identification of patients with a low likelihood for adjuvant radiotherapy than currently used clinical parameters.Patients and MethodsIn a cohort study, International Federation of Gynecology and Obstetrics (FIGO) stage, tumor size, and preoperative serum SCC-ag levels, as determined by enzyme immunoassay, were related to the frequency of postoperative indications for adjuvant radiotherapy in 337 surgically treated, FIGO stage IB/IIA, squamous cell cervical cancer patients.ResultsIn patients with normal preoperative SCC-ag, 16% of IB1 and 29% of IB2/IIA had postoperative indications for adjuvant radiotherapy, in contrast to 57% of IB1 and 74% of IB2/IIA patients with elevated (> 1.9 ng/mL) serum SCC-ag (P < .001). Serum SCC-ag was the only independent predictor for a postoperative indication for radiotherapy (odds ratio, 7.1; P < .001). Furthermore, in IB1 patients that did not have indications for adjuvant radiotherapy, 15% of patients with elevated preoperative serum SCC-ag levels recurred within 2 years, compared with 1.6% of patients with normal serum SCC-ag levels (P = .02).ConclusionIn early-stage cervical cancer, determination of serum SCC-ag levels allows more refined preoperative estimation of the likelihood for adjuvant radiotherapy than current clinical parameters, and simultaneously identifies patients at high risk for recurrence when treated with surgery only. The role of preoperative serum SCC-ag in the management of patients with early-stage cervical cancer deserves further investigation.

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