Abstract
The aim of this study is to determine the prognostic value of tumor markers, as squamous cell carcinoma antigen (SCCAg) and cytokeratin-19 fragment (CYFRA 21.1) and interleukin 6 (IL-6), vascular endothelial growth factor (VEGF), soluble tumor necrosis factor receptor I (sTNF RI), and sTNF RII in patients with squamous cell carcinoma of the cervix. The subjects of analysis were 138 patients with stage I–IVA according to the International Federation of Gynecology and Obstetrics (FIGO) classification. The collected research material comes from one oncology center. During the 10 years of follow-up, 56 relapses and 53 deaths were observed, and recurrent disease in early stage was confirmed in 45 % of patients. The pretreatment serum levels of SCCAg and CYFRA 21.1, and cytokines IL-6, VEGF, sTNF RI, and sTNF RII were determined in all patients. The probability of disease-free survival (DFS) and overall survival (OS) was evaluated using the log-rank test and the Cox regression model. Based on the ROC curve analysis for patients with recurrence, the largest area under the curve was demonstrated for SCCAg and IL-6 and for patients who died, for SCCAg and VEGF. Cox analysis demonstrated that independent prognostic factor for DFS was only SCCAg and for OS cytokine IL-6 and SCCAg, but in patients with early stage the prognostic value for DFS was VEGF, whereas IL-6 and CYFRA 21.1 for OS. Serum level of VEGF, CYFRA 21.1 and IL-6 before treatment in patients with early stage cervical cancer appears to be an important prognostic factor.
Highlights
Due to well-developed screening programs, the incidence of cervical cancer, especially squamous cell carcinoma (SCC), has decreased dramatically, cervical cancer is still the third most diagnosed cancer and the fourth highest cause of death among females around the world [1].Some pathologic features, such as tumor diameter, lymph node involvement, lymph vascular space invasion, extend of the tumor, and depth of stromal invasion, have been proven as clinically important [2]
The aim of the study was to determine the prognostic value of pretreatment serum levels of the cytokines interleukin 6 (IL-6), vascular endothelial growth factor (VEGF), soluble tumor necrosis factor receptor and sTNF RII in patients with SCC of the cervix and the tumor markers
Cervical cancer is a malignancy of the reproductive tract derived from a variety of cell types
Summary
Due to well-developed screening programs, the incidence of cervical cancer, especially squamous cell carcinoma (SCC), has decreased dramatically, cervical cancer is still the third most diagnosed cancer and the fourth highest cause of death among females around the world [1]. Some pathologic features, such as tumor diameter, lymph node involvement, lymph vascular space invasion, extend of the tumor, and depth of stromal invasion, have been proven as clinically important [2]. Several methods are available for recurrence detection, but the disease is usually advanced with the accompanying clinical symptoms. In studies presented by Scambia et al and Strausss et al, 74–88 % of patients presented an elevation of SCCAg with association of disease, while 70–86 % of recurred patients were proven to have elevated SCCAg [5, 6]
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