Abstract
To determine the potential clinical utility of tumor markers CEA, TPA, and SCC-Ag for early detection of cervical precancerous lesions. A case-control study was carried out on 120 women (46 patients with histologically confirmed cervical precancerous lesions and 74 healthy controls). The significance of serum selected tumor markers in early detection of cervical intraepithelial neoplasia (CIN) were assessed. Of the case group, the rates of CIN I, II, III, was 69.6%, 23.9%, and 6.5%, respectively. According to the manufacturer's cut-off values of 2 ng/ml, 5 ng/ml, and 70 U/ml for SCC-Ag, CEA and TPA tests, in that order, SCC-Ag test had a sensitivity of 13%, but CEA and TPA tests could not distinguish between case and control groups. The diagnostic sensitivities were highest at cut-off values of 0.55 ng/ml for SCC-Ag, 2.6 ng/ ml for CEA, and 25.5 U/ml for TPA which were 93%, 61%, and 50%, respectively. However, the area under the receiver operating characteristic curve was the largest for SCC-Ag (0.95 vs. 0.61 and 0.60 for CEA and TPA, respectively). Moreover, there was a highly significant direct correlation between SCC-Ag concentration and the degree of cervical precancerous lesions (r=0.847, p<0.001). The new cutoff of 0.5 for SCC-Ag test might be useful as a tumor marker in Iranian patients with CIN and it needs to be more evaluated by studies with larger populationa.
Highlights
Cancer of cervix is the third most common cancer and the fourth leading cause of cancer death of women worldwide
There was a significant difference between two groups in the number of women with history of sexual intercourse before the age of 16 years which was reported in 25 (54.3%) and 6 (8.1%) women in cases and controls, respectively (OR=3.4, 95%confidence interval (CI) 2.26-5.16, p
Our study found that squamous cell carcinoma antigen (SCC-Ag) can detect the presence of cervical precursors among Iranian women with a high sensitivity of 93% and an acceptable specificity of 96% when its upper limit was 0.55ng/ml
Summary
Cancer of cervix is the third most common cancer and the fourth leading cause of cancer death of women worldwide. Screening programs for detection of cervical cancer precursors using Papanicolaou cytological testing (Pap smear) has shown to be very successful in developed countries, so that effective reduction in the incidence of cervical cancer by 75% to 90% as well as decrease in its related mortality by 50% occurred in industrial world (Wallace et al, 2007; Cuzick et al, 2008) The lack of such appropriate screening programs has led to high burden of cervical cancer in low resource countries (Parkin et al, 2008; Mathew and George 2009) where about 83% of new cases and 85% of cervical cancer deaths are reported from developing world (Porika et al, 2010). Conclusions: The new cutoff of 0.5 for SCC-Ag test might be useful as a tumor marker in Iranian patients with CIN and it needs to be more evaluated by studies with larger populationa
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