Pretreatment Serum Squamous Cell Carcinoma Antigen Research Articles

Could Adjuvant Chemotherapy Improve Prognosis for Cervical Cancer Patients with Elevated Pretreatment Serum Squamous-Cell Carcinoma Antigen?

ObjectiveThe aim of this study was to explore whether adjuvant chemotherapy could improve prognosis for cervical cancer patients with elevated pretreatment serum squamous-cell carcinoma antigen (SCC-Ag).MethodsPropensity-score matching and inverse probability of treatment weighting (IPTW) were used to ensure balanced groups for patients with (arm A) and without adjuvant chemotherapy (arm B). All patients were treated between January 2012 and December 2014 at a single center. Study outcomes were disease-free survival (DFS) and overall survival (OS).ResultsIn total, 81 patients were included in this study. By propensity-score matching, 35 patients were included in each group (arm A and arm B). Median follow-up was 60 months in arm A and 66 months in arm B. Overall, 85.7% of patients in arm A and 71.4% of those in arm B received adjuvant radiotherapy. DFS and OS curves were similar between arms A and B (P=0.971 and 0.633, respectively). With IPTW, arm A was not associated with prognosis in terms of DFS (HR 0.946, 95% CI 0.237–3.784; P=0.938) or OS (HR 1.020, 95%CI 0.357–2.913; P=0.970).ConclusionFor patients with elevated pretreatment SCC-Ag, adjuvant chemotherapy was not found to improve prognosis. Also, a considerable proportion of these patients had postoperative indications for adjuvant radiotherapy. For these cervical cancer patients with elevated pretreatment SCC-Ag, the choice of radical hysterectomy and adjuvant chemotherapy should be prudent.

Pretreatment Squamous Cell Carcinoma Antigen (SCC-Ag) as a Predictive Factor for the Use of Consolidation Chemotherapy in Cervical Cancer Patients After Postoperative Extended-Field Concurrent Chemoradiotherapy.

Objective: The goal of this study was to confirm the clinical value of pretreatment serum squamous cell carcinoma antigen (SCC-Ag) in the administration of consolidation chemotherapy in patients with cervical cancers undergoing postoperative extended-field radiotherapy (EFRT) and concurrent chemotherapy (CCRT). Methods: Between 2007 and 2018, a total of 113 patients were treated with postoperative extended-field intensity-modulated radiotherapy (EF-IMRT) and CCRT. There were 63 patients receiving extended-field concurrent chemoradiotherapy (EF-CCRT) and consolidation chemotherapy, while another 50 patients underwent EF-CCRT alone. For the planning target volume, the prescribed dose was 45 to 50.4Gy/25 to 28 fractions. The consolidation chemotherapy regimen contained docetaxel and cisplatin. Results: For the patients with high pretreatment SCC-Ag, the addition of consolidation chemotherapy significantly improved their treatment outcomes and they had better 5-year overall survival (OS) (81.02% vs 63.44%, P = .018) and disease-free survival (DFS) (76.95% vs 61.12%, P = .007) than those without it. Meanwhile, the patients with consolidation chemotherapy had a lower rate of distant metastasis (8.8% vs 34.8%, P = .001). For the patients with low pretreatment SCC-Ag, there was no difference in prognosis between patients receiving consolidation chemotherapy and those not receiving consolidation. In multivariate analysis, consolidation chemotherapy was found to be a factor significantly associated with DFS (P = .035, 95% confidence interval (CI): 0.304-0.977) and distant metastasis (P = .009, 95% CI: 0.125-0.841). Conclusion: The patients who received consolidation chemotherapy showed significantly better DFS. Furthermore, pretreatment serum SCC-Ag > 6.5 ng/mL may be a predictive factor for the use of consolidation chemotherapy in cervical cancer patients treated with postoperative EF-CCRT.

Association of pretreatment SUVmax of cervix and SCC-antigen with FIGO2018 stage in Stage IIB-IVB squamous cervical cancer and relationship to prognosis.

To evaluate the association of pretreatment maximum standardized 18 F-fluorodeoxyglucose uptake value (SUVmax ) of cervix and serum squamous cell carcinoma antigen (SCC-ag) with FIGO2018 stage and prognosis among women with Stage IIB-IVB squamous cervical cancer. Retrospective study of 116 women with FIGO2018 Stage IIB-IVB cervical cancer treated in Hangzhou, China, 2013-2015. The relationship between pretreatment SUVmax or SCC-ag and prognostic factors was evaluated by univariate and multivariate analyses. Women were stratified by mean SUVmax and mean SCC-ag. There was a significant difference between low (<12.9) and high (≥12.9) SUVmax groups in menopause (P=0.004), FIGO2018 stage (P=0.015), and survival rate (P<0.001). The low group had better overall and progress-free survival by Kaplan-Meier evaluation (both P=0.022). High SCC-ag (≥14.6ng/mL) was associated with FIGO2018 stage (P=0.038) and distant metastasis (P=0.011). There was a significant correlation between SUVmax and serum SCC-ag (P=0.026). In multivariate Cox regression analyses, FIGO2018 stage (P=0.019) and SUVmax of cervix (P=0.015) were independent predictors of poor outcome in squamous cervical cancer. Both SUVmax of cervix and SCC-ag were associated with FIGO2018 stage in squamous cervical cancer. Pretreatment high SUVmax of cervix and advanced FIGO2018 stage might indicate a poor prognosis.

Clinical value of serum squamous cell carcinoma antigen levels in predicting chemosensitivity, lymph node metastasis, and prognosis in patients with cervical squamous cell carcinoma

BackgroundOur aim was to investigate the value of serum squamous cell carcinoma (SCC) antigen levels in predicting chemosensitivity, lymph node metastasis, as well as prognosis in patients with cervical squamous cell carcinoma who received neoadjuvant chemotherapy (NACT).MethodsThis retrospective study enrolled 103 patients with cervical squamous cell carcinoma and then compared the SCC antigen levels between patients who underwent NACT followed by radical surgery (NACT group) and those who underwent radical surgery alone (conventional group), and a correlation analysis between SCC antigen levels and chemosensitivity, lymph node metastasis, or survival time was conducted.ResultsThe SCC antigen levels changed after NACT and were associated with chemosensitivity. Moreover, the optimal cut-off value of the percentage decrease in SCC antigen level after the first chemotherapy (FSCC (%)) was 42.0%, which could be used for assessment of chemosensitivity. The rate of positive lymph nodes in patients with pretreatment SCC antigen levels ≥3.9 ng/mL was significantly decreased after NACT. The overall survival (OS) of NACT group was significantly longer than that of conventional group when the pretreatment SCC antigen levels were ≥ 4.55 ng/mL. The OS and progression-free survival rates of patients with SCC antigen levels < 2.7 ng/mL were longer than those ≥2.7 ng/mL after the first chemotherapy.ConclusionsThe 42.0% of FSCC (%) after NACT is a reliable indicator of chemosensitivity. Pretreatment and posttreatment SCC antigen levels can be used in evaluating the lymph node metastases and prognosis of patients with cervical squamous cell carcinoma.

Expression and prognostic value of cytokeratin 19 fragment antigen 21-1 and squamous cell carcinoma antigen in cervical cancer patients with lung metastasis

Objective To investigate expression of cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) and squamous cell carcinoma antigen (SCC-Ag) in cervical cancer patients with lung metastasis before treatment and their prognostic value. Methods The pretreatment serum expression levels of SCC-Ag and CYFRA21-1 of 72 cervical cancer patients with lung metastasis were measured. Survival rate analysis and Cox proportional hazard model were performed to evaluate the prognostic significance of two pretreatment variables. Results The media survival time (MST) of 72 patients was 14 months, and 38 (52.8 %) patients with pulmonary metastasis occurred in 1 year of treatment. The pretreatment serum SCC-Ag and CYFRA21-1 levels in the patients with tumor diameter over 4 cm or with squamous cell carcinoma were higher than those in the other patients (all P 3.3 mg/L) was higher than that in the negative group (13 months vs 19 months, P 1.5 mg/L) was also higher than that in the negative group (14 months vs 21 months, P < 0.05). The result of Cox regression analysis showed that the tumor diameter (OR = 11.6, P = 0.01), pretreatment serum SCC-Ag (OR = 4.2, P= 0.01) and CYFRA21-1 (OR = 8.2, P= 0.05) levels were independent prognostic factors of overall survival. Conclusion Pretreatment CYFRA 21-1 and SCC-Ag levels may be considered as useful prognostic indicators for cervical cancer patients with lung metastasis. Key words: Cervical neoplasms; Lung metastasis; Cytokeratin 19 fragment antigen 21-1; Squamous cell carcinoma antigen

The Correlation Between the Serum Squamous Carcinoma Antigen and the Prognosis of Recurrent Cervical Squamous Carcinoma.

To explore the relationship of the serum squamous cell carcinoma antigen (SCC-Ag) with the pathologic characteristics, occurrence, and prognosis of cervical squamous carcinoma. The enzyme-linked immunosorbent assay (ELISA) method was used to determine the serum SCC-Ag levels for the patients, which included 424 pretreatment patients and 500 cases after treatment. (a) Pretreatment SCC-Ag levels of patients were related to clinical stages, lymphatic metastasis, and myometrial invasion, (b) within a median follow-up of 54 months, 180 recurrences (36%) and 102 disease-associated deaths (20.4%) were recorded, 161 recurrent patients showed elevated SCC-Ag levels (161/180, 89.4%), and 60 of them (37.3%) had a significant increase in SCC-Ag serum levels before clinical manifestation of relapse. The lead time ranged between 1 and 5 months (median: 2.3 months). The total survival rates were 23.4% and 17.8% for 3-year and 5-year period, respectively, and (c) clinical stages, the site of recurrence, and SCC-Ag levels after treatment were closely related with recurrent patients' survival time (P < 0.01~<0.005). Multivariate analysis indicated that the clinical stages and SCC-Ag levels of recurrent patients were independent prognostic factors (P < 0.05˜0.01). Serum SCC-Ag level was an important predictor for the cervical squamous carcinoma recurrence and prognosis.

Pretreatment serum CYFRA 21-1 level correlates significantly with survival of cervical cancer patients: A multivariate analysis of 506 cases

ObjectiveTo determine whether pretreatment CYFRA 21-1 levels can be a useful prognostic indicator in cervical cancer with reference to squamous cell carcinoma-antigen (SCC-Ag). MethodsWe retrospectively analyzed data on 506 consecutive cervical cancer patients who were treated by radical hysterectomy or primary concurrent chemoradiation therapy. The pretreatment serum SCC-Ag and serum CYFRA 21-1 levels were measured in these patients. A multivariate analysis using Cox's proportional hazard model was performed to evaluate the prognostic significance of pretreatment variables. ResultsIn patients who underwent radical hysterectomy, there was a significant correlation between pretreatment serum SCC-Ag/CYFRA 21-1 levels and patient age, advanced FIGO stage, large tumor size, lymph node metastasis, and deep stromal invasion. In the stepwise Cox regression analysis, large tumor size >4cm was an independent prognostic factor for disease-free survival (OR, 3.110; [95% CI, 1.588–6.093], P=0.001) and overall survival (OR, 8.497; [95% CI, 1.797–40.184], P=0.007) in patients with squamous cell carcinoma, while pretreatment CYFRA 21-1 (P=0.010) serum levels had a significant independent effect on overall survival. Likewise, pretreatment CYFRA 21-1 (P<0.001 and P=0.006) serum levels were the only independent prognostic factor for disease-free survival and overall survival in patients with non-squamous cell carcinoma. ConclusionPretreatment CYFRA 21-1 levels may be considered as a useful prognostic indicator in cervical cancer with reference to SCC-Ag.

Squamous cell carcinoma antigen

The objective of this retrospective study was to investigate the predictive value of pretreatment serum squamous cell carcinoma antigen (SCCAg) levels in 174 patients with squamous cell carcinoma of the anus who received concurrent chemoradiation between 1997 and 2010. Pretreatment serum SCCAg measurements in patients with histologically diagnosed squamous cell carcinoma of the anal canal and margin who received chemoradiation were compared with clinical tumor classification and lymph node status for prognostic/predictive ability, including 1) tumor response after the completion of chemoradiation treatment, 2) disease recurrence, and 3) overall survival. Clinical measurements and scores were compared using Spearman rank tests, and survival was assessed in both univariate and multivariate survival analyses. The median pretreatment levels of SCCAg according to clinical tumor classification and clinical lymph node status were 0.8 μg/L in T1 tumors, 1.90 μg/L in T2 tumors, 2.5 μg/L in T3 tumors, 3.8 μg/L in T4 tumors, 1.35 μg/L in patients with N0 status, and 3.05 μg/L in patients with N0+ status (correlation coefficient: T-classification, 0.43; lymph node status, 0.38; both P < .00001). Of the patients who had normal SCCAg levels, 95% achieved a complete response after initial treatment; and, of those who had elevated SCCAg levels, 86% achieved a complete response (P = .05). Overall survival (hazard ratio, 2.5; P = .007) and disease-free survival (hazard ratio, 2.2; P = .058) were worse for those who had elevated pretreatment serum SCCAg concentrations. Pretreatment SCCAg levels in patients with squamous cell carcinoma of the anal canal and margin were correlated with clinical tumor classification and clinical lymph node status. Elevated levels of SCCAg were associated with a reduced chance of achieving a complete response and an increased chance of recurrence and death. The authors recommend further studies to determine the prognostic value of SCCAg in anal squamous cell carcinoma and suggest the potential use of SCCAg as a stratification factor in future trials.

Clinical significance of serum squamous cell carcinoma antigen in the diagnosis, treatment and prognosis of cervical squamous cell carcinoma

To explore the clinical significance of squamous cell carcinoma antigen (SCC-Ag) in the diagnosis, treatment and prognosis of cervical squamous cell carcinoma. The serum SCC-Ag concentrations were measured for 1195 patients with cervical squamous cell carcinoma, 54 patients with non-squamous cell type cervical cancer, 325 patients with cervical intraepithelial neoplasm and 69 healthy women treated at Gynecology Ward of Shengjing Hospital, China Medical University from August 2008 to October 2010. And the correlations with their clinical pathological features of squamous cell carcinoma were analyzed and the changes in the diagnosis, treatment and prognosis monitored. Serum SCC-Ag in patients with cervical squamous cell carcinoma showed a sensitivity of 62.32% and a specificity of 90.10% with the optimal cutoff point of diagnosis at 1.45 µg/L. The differences of pretreatment serum SCC-Ag levels were statistically significant in clinical stage, histological differentiation, depth of invasion and lymph node metastasis (P < 0.01). The posttreatment serum SCC-Ag levels of 106 patients undergoing radical surgery and 264 patients on chemotherapy significantly decreased and were significant different with their pretreatment levels (P < 0.05). There was no relationship of serum SCC-Ag levels and human papillomavirus (HPV) opportunistic infection (all P > 0.05). The best threshold values of pretreatment serum SCC-Ag concentration for predicting early postoperative cervical lymph node metastasis and prognosis of cervical cancer were 2.15 and 12.1 µg/L respectively. As a relatively specific tumor maker for cervical squamous cell carcinoma, squamous cell carcinoma antigen is correlated with clinicopathological features of cervical squamous cell carcinoma. And it has important clinical reference values in the diagnosis, prognosis, follow-up evaluation and treatment monitoring of cervical squamous cell carcinoma.

The SUVmax (maximum standardized uptake value for F-18 fluorodeoxyglucose) and serum squamous cell carcinoma antigen (SCC-ag) function as prognostic biomarkers in patients with primary cervical cancer

The aim of the present study was to investigate the prognostic significance of FDG uptake measured as maximum standardized uptake value (SUVmax) in primary tumor by positron emission tomography with fluorine-18-fluorodeoxyglucose (FDG-PET/CT) and pretreatment serum squamous cell carcinoma antigen (SCC-ag) in patients with cervical cancer. 82 consecutive patients with biopsy-proven cervical cancer who had PET/CT before any treatment were enrolled in this study. The SUVmax of the primary cervical tumor mass was obtained and compared with pretreatment SCC-ag and pathological prognostic factors after the initial treatment. There was significant correlation between the SUVmax of the primary tumor and tumor maximum size (p = 0.0024). The serum SCC-ag had a statistically significant association with lymph node metastasis (p = 0.0373), although there was no correlation between the SUVmax of the primary tumor and the serum SCC-ag (r (2) = -0.57). The higher SUVmax of primary tumor (≥11.2) plus pelvic lymph node (PLN) metastasis and higher SUVmax plus higher serum SCC-ag (≥6.4 ng/nl) were two most significant variables that predicted worse prognosis (p = 0.0099 and p = 0.0020, respectively). Higher pretreatment SUVmax of primary tumor indicated worse prognosis, and the prognosis of patients with higher pretreatment SUVmax plus PLN metastasis was even worse both in patients of squamous cell carcinoma (SCC) and non-SCC of cervix. As for patients with SCC of cervix, higher pretreatment serum SCC-ag not only predicted worse prognosis but also predicted disease recurrence in the posttreatment surveillance.

Serum squamous cell carcinoma antigen and CYFRA 21-1 in cervical cancer treatment

Purpose : To analyze whether serum squamous cell carcinoma (SCC) antigen and cytokeratin-19 fragments (CYFRA) levels can assist in selecting patients with locally advanced cervical cancer who will benefit from combined treatment or additive surgery. Methods and Materials : Of 114 patients with cervical cancer Stage IB–IV, the first 39 patients received radiotherapy, the following 75 patients received identical radiotherapy plus concomitant chemotherapy (3 cycles of carboplatin and 5-fluorouracil). SCC antigen and CYFRA 21-1 serum levels were measured before treatment, after therapy, and during follow-up. Baseline tumor markers were related to tumor stage and size and clinical outcome. Results : Before treatment, SCC antigen was elevated (>1.9 μg/L) in 60% and CYFRA 21-1 (>2.2 μg/L) in 46% of patients. For all patients, disease-free survival (DFS) was better after combined treatment (67% vs. 43%, p < 0.0005). For patients with elevated baseline SCC antigen, DFS was better after combination therapy (67% vs. 27%, p = 0.001) which resulted more frequently in a normal SCC antigen (93% vs. 65%, p = 0.004). In contrast, in those with a normal baseline CYFRA 21-1, combined therapy resulted in a better DFS ( p = 0.04). Patients who achieved a normal SCC antigen or CYFRA 21-1 after treatment had a better DFS (respectively 63 vs. 17% and 64 vs. 30%). Elevated SCC antigen posttreatment indicated residual tumor in 11/12 patients (92%), elevated CYFRA 21-1 in 7/10 patients (70%). Forty-seven patients had a tumor recurrence. At recurrence, SCC antigen was raised in 70% and CYFRA 21-1 in 69%. Conclusions : In patients with an elevated pretreatment SCC antigen, SCC antigen normalized more frequently with combined treatment and those patients had a better DFS. Elevated SCC antigen or CYFRA 21-1 levels after treatment completion indicated residual tumor in respectively 92% and 70%. The presence of elevated posttreatment levels of SCC antigen or CYFRA 21-1 indicates the need for additional salvage surgery. SCC antigen proved to be superior to CYFRA 21-1 in predicting DFS and disease recurrence.

The Clinical Value of Squamous Cell Carcinoma Antigen in Cancer of the Uterine Cervix

A review is given of the clinical use and interpretation of serum tumor marker levels during the treatment of patients with cancer of the uterine cervix. Pretreatment serum squamous cell carcinoma (SCC) antigen provides a new prognostic factor in early stage squamous cell carcinoma of the uterine cervix. Elevated serum values of SCC antigen at the time of diagnosis of stage IB and IIA cervical cancer indicate a 3 × increased risk of tumor recurrence, independent of tumor diameter, grade or the presence of lymph node metastases. High pretreatment SCC antigen levels could therefore be used to select ‘high-risk’ patients for adjuvant therapy. Measurement of the serum SCC antigen levels provides a means of monitoring the effect of therapy. During the postoperative follow-up of patients with localized cancer of the uterine cervix the measurement of SCC antigen can lead to the early detection of recurrent disease when curative therapy is still an option. The profile of serum SCC antigen parallels the response to radiotherapy and provides a way of evaluating the effectiveness of chemotherapy. Serial measurements after surgery and during radio- and chemotherapy demonstrate that SCC antigen is a more sensitive marker for recognizing tumor progression or recurrence than CYFRA-21.1, TPS or CEA. When following up patients with a pure adenocarcinoma of the cervix measurements of serum CA 125 and CEA are preferred over SCC antigen measurements.

Pretreatment serum squamous cell carcinoma antigen: a newly identified prognostic factor in early-stage cervical carcinoma.

To investigate the prognostic value of pretreatment serum squamous cell carcinoma antigen (SCC-ag) levels in patients with cervical squamous cell carcinoma in relation to well-established conventional risk factors. Sera from 653 women treated for squamous cervical cancer between 1978 and 1994 were analyzed for the presence of SCC-ag and related to clinicopathologic characteristics and patient outcome using univariate and multivariate analyses. Increased pretreatment SCC-ag levels correlated strongly with unfavorable clinicopathologic characteristics (International Federation of Gynecology and Obstetrics [FIGO] stages IB to IV [P < or = .00005]; stages IB and IIA: tumor size [P = .0236], deep stromal infiltration [P = .00009], and lymph node metastasis [P = .0001]). After multivariate analysis, elevated pretreatment serum SCC-ag levels (P = .001), lesion size (P = .043), and vascular invasion by tumor cells (P = .001) were independent predictors for the presence of lymph node metastases. In Cox regression analysis, controlling for SCC-ag, lesion size, grade, vascular invasion, depth of stromal infiltration, and lymph node status only the initial SCC-ag level had a significant independent effect on survival (P = .0152). Even in node-negative patients, the risk of recurrence was three times higher if the SCC-ag level was elevated before therapy. The determination of pretreatment serum SCC-ag level provides a new prognostic factor in early-stage disease, particularly in patients with small tumor size. In future trials to assess the value of new treatment strategies, pretreatment serum SCC-ag levels can be used to help identify patients with a poor prognosis.