Squamous Cell Carcinoma Antigen Levels Research Articles

A Preoperative Nomogram for Predicting Chemoresistance to Neoadjuvant Chemotherapy in Patients with Locally Advanced Cervical Squamous Carcinoma Treated with Radical Hysterectomy.

PurposeThis study aimed to investigate the factors associated with chemoresistance to neoadjuvant chemotherapy (NACT) followed by radical hysterectomy (RH) and construct a nomogram to predict the chemoresistance in patients with locally advanced cervical squamous carcinoma (LACSC).Materials and MethodsThis retrospective study included 516 patients with International Federation of Gynecology and Obstetrics (2003) stage IB2 and IIA2 cervical cancer treated with NACT and RH between 2007 and 2017. Clinicopathologic data were collected, and patients were assigned to training (n=381) and validation (n=135) sets. Univariate and multivariate analyses were performed to analyze factors associated with chemoresistance to NACT. A nomogram was built using the multivariate logistic regression analysis results. We evaluated the discriminative ability and accuracy of the model using a concordance index and a calibration curve. The predictive probability of chemoresistance to NACT was defined as > 34%.ResultsMultivariate analysis confirmed menopausal status, clinical tumor diameter, serum squamous cell carcinoma antigen level, and parametrial invasion on magnetic resonance imaging before treatment as independent prognostic factors associated with chemoresistance to NACT. The concordance indices of the nomogram for training and validation sets were 0.861 (95% confidence interval [CI], 0.822 to 0.900) and 0.807 (95% CI, 0.807 to 0.888), respectively. Calibration plots revealed a good fit between the model-predicted probabilities and actual probabilities (Hosmer-Lemeshow test, p=0.597). Furthermore, grouping based on the nomogram was associated with progression-free survival.ConclusionWe developed a nomogram for predicting chemoresistance in LACSC patients treated with RH. This nomogram can help physicians make clinical decisions regarding primary management and postoperative follow-up of the patients.

Detection of Recurrent Cervical Cancer and Prediction of Its Patient Survival with Serum Squamous-Cell Carcinoma-Antigen and 2-[18F] Fluoro-2-Deoxy-d-Glucose-Positron Emission Tomography/Computed Tomography.

Aim: To evaluate the usefulness of serum squamous-cell carcinoma antigen (SCC-Ag) and 2-[18F]fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) for the detection of recurrent squamous-cell carcinoma (SqCC) of the uterine cervix, and its prediction of patient survival. Methods: FDG-PET/CT was performed for patients with serum SCC-Ag levels elevated to ≥1.5 ng/mL (Group 1) and those with suspicious recurrences without any increase in serum SCC-Ag levels (Group 2). The results were analyzed on the basis of histological data, disease progression and/or clinical follow-up. Recurrence was defined as evidence of recurrent lesions within 6 months of FDG-PET/CT. The outcome was determined using medical records. Results: In total, 88 consecutive patients with cervical SqCC cancer with suspected recurrence (62 in Group 1 and 26 in Group 2) were enrolled. Recurrences were observed in 55 patients (77.4% (48/62) in Group 1 vs. 26.9% (7/26) in Group 2, p < 0.001). The overall sensitivity, specificity and accuracy of serum SCC-Ag were 87.3%, 57.6% and 76.1%, respectively, and those of FDG-PET/CT were 98.2%, 90.9% and 95.5%, respectively; the corresponding values were 97.9%, 92.9% and 96.8% for Group 1 and 100%, 89.5% and 92.3% for Group 2. Surgical resection was performed for 16 patients. At the end of the study, 40.3% (25/62) of Group 1 patients and 88.5% (23/26) of Group 2 patients were alive (p < 0.001). The survival of patients who underwent surgical resection for recurrent tumors was higher than that of patients who did not undergo resection (62.5% (10/16) vs. 17.9% (7/39), p = 0.001). Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) derived from FDG-PET/CT showed significantly different in-patient survival. Conclusions: Serum SCC-Ag could predict tumor recurrence and the survival of patients with SqCC cervical cancer. As such, the surgical resection of limited recurrent disease, as determined using FDG-PET/CT, might improve the survival of patients with cervical cancer. MTV and TLG may serve as a prognostic biomarker of survival in patients with recurrent cervical cancer.

The Efficacy of Squamous Cell Carcinoma Antigen in the Differential Diagnosis of Oral squamous Cell Carcinoma.

Abstract Background and Objectives: Oral squamous cell carcinoma (OSCC) is a major oral cancer representative. Squamous cell carcinoma antigen (Scc-AG) is detected in squamous cell carcinoma of oral tissues and other different tissues. Oral lichen planus (OLP) is a chronic inflammatory disease with questionable malignant transformation. Methods: Forty-five participants divided into OSCC group and two control groups: oral lichen planus as an inflammatory disease (positive control) and healthy volunteers (negative control). Clinical staging and grading of OSCC was recorded. A double-antibody sandwich enzyme-linked immunosorbent assay was used to evaluate the level of Scc-AG in serum and saliva. Results: Statistically significant difference for serum and salivary Scc-Ag, was found between the groups; OSCC, OLP on one hand and healthy controls on the other hand. No statistically significant difference was found between OSCC and OLP control groups in serum levels, while for salivary Scc-Ag a statistically significant difference was found between these two groups, with the higher values in OLP. Staging and grading in OSCC group were not found to be related to Scc-Ag level. Conclusion: Serum Scc-Ag cannot be used as a biomarker to differentiate between oral malignant and chronic inflammatory lesions. On the other hand, salivary Scc-Ag determination provides results more reliable than serum Scc-Ag and could be used in monitoring inflammatory oral disease activity as well as malignant conditions and could differentiate between them.

Expression levels of SCCA and CYFRA 21-1 in serum of patients with laryngeal squamous cell carcinoma and their correlation with tumorigenesis and progression.

To explore the concentration of squamous cell carcinoma antigen (SCCA), cytokeratin fragment antigen21-1 (CYFRA21-1) in patients with laryngeal squamous cell carcinoma (LSCC) and its correlation with tumorigenesis and progression. A total of 78 patients with LSCC admitted to our hospital from February 2010 to January 2016 were enrolled as the research group (RG), and another 41 healthy volunteers from the same period were selected as the control group (CG). The serum concentrations of SCCA and CYFRA21-1 in patients with LSCC were detected by ELISA, whose diagnostic value in LSCC were further analyzed by ROC curve. The prognosis and survival curves of patients with LSCC were observed according to the median value of serum SCCA and CYFRA21-1 concentrations. The concentration of CYFRA21-1 and SCCA in the RG was significantly higher than that in the CG (p < 0.050). The SCCA and CYFRA21-1 identified a significant difference in smoking, lymphatic metastasis, TNM staging, and differentiation degree (p < 0.050). The survival rate of the SCCA low-concentration group was significantly better than that of the high-concentration group, p < 0.050. The survival rate of the CYFRA21-1 low-concentration group was markedly better than that of the high-concentration group, p < 0.050. SCCA and CYFRA21-1 are highly concentrated in LSCC patients, which have good diagnostic efficacy for LSCC. In addition, they play some certain role in the occurrence and development of LSCC, and are expected to be markers for early diagnosis and prognosis of this disease.

Clinical Significance of Pretherapeutic Serum Squamous Cell Carcinoma Antigen Level in Patients with Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma.

Although squamous cell carcinoma antigen (SCC-Ag) is a tumor marker widely used to estimate the progression of esophageal SCC (ESCC), only a few studies have focused on the relationship between serum SCC-Ag levels and the therapeutic effect of neoadjuvant chemotherapy (NAC). This study aimed to elucidate the clinical significance of pretherapeutic serum SCC-Ag levels in patients who underwent NAC followed by esophagectomy. Data of 453 patients who underwent NAC followed by esophagectomy were collected from the esophageal cancer database of two high-volume Japanese centers. Serum SCC-Ag levels were measured prior to NAC, and the pathological therapeutic effect of NAC and patient survival were evaluated. Patients were classified according to the tertiles of the serum SCC-Ag value (low, middle, and high groups), and the outcomes among the groups were compared. The levels of serum SCC-Ag were significantly associated with tumor stage (p<0.01). With regard to the pathological therapeutic effect, the levels of serum SCC-Ag were negatively correlated with the therapeutic effect (p=0.02). Moreover, increased levels of serum SCC-Ag negatively influenced relapse-free survival (p<0.01). Multivariate analyses revealed the 'high' group as the independent factor for both the unfavorable therapeutic effect (p=0.01) and the increased risk of disease recurrence (p<0.01) when compared with the 'low' group. Elevated levels of pretherapeutic serum SCC-Ag are significantly associated with advanced tumor stage, poor response to NAC, and increased risk of disease recurrence.

Expression of immune cell markers and tumor markers in patients with cervical cancer

ObjectiveCervical cancer is one of the most common cancers worldwide, and immune function may impact disease progression. Serum markers may also be associated with diagnosis and progression. The aim of...

Preoperative squamous cell carcinoma antigen and albumin serum levels predict the survival of patients with stage T1-3N0M0 esophageal squamous cell carcinoma: a retrospective observational study

BackgroundThis study aimed to explore the significance of preoperative levels of squamous cell carcinoma antigen (SCC-Ag) and albumin on the cancer-specific survival (CSS) of patients with stage T1-3N0M0 in esophageal squamous cell cancer (ESCC).MethodsThe data of 308 patients who underwent esophagectomy between 1996 and 2011 were analyzed. SCC-Ag and albumin levels were measure 1 week before surgery. The optimal cutoff levels of SCC-Ag and albumin were determined using the X-Tile software, which were 1.0 μg/L and 39.8 g/L, respectively. The associations between SCC-Ag and albumin levels and clinicopathological characteristics were assessed using the χ2 test, Student’s t-test and Fisher’s exact test. Cox univariable and multivariable analyses were computed to identify SCC-Ag and albumin levels as independent prognostic factors related to the CSS of patients with ESCC. We used the Kaplan-Meier survival curve to determine the significance of SCC-Ag and albumin level on ESCC in the long-term follow-up.ResultsThe 5-year CSS rate for the entire cohort was 65.0%. There was a significant difference in CSS between the low and high SCC-Ag level groups (hazard ratio [HR], 1.828, 95% confidence interval [CI], 1.203–2.778; P = 0.005). Patients with ESCC with low albumin level had a worse CSS than those with high albumin level (HR, 0.540; 95% CI, 0.348–0.838; P = 0.006). Patients with both high SCC-Ag and low albumin levels had worse 5-year CSS than patients with low SCC-Ag and high albumin levels (P < 0.05).ConclusionsPreoperative serum SCC-Ag and albumin levels can predict survival in patients ESCC with stage T1-3N0M0. Patients with ESCC with high SCC-Ag and low albumin levels may have a poor survival outcome.

Prognostic factors in women with cervical cancer stage IIIC1r treated with concurrent chemoradiotherapy.

The purpose of this study was to evaluate the prognostic factors of patients with stage IIIC1r cervical cancer who underwent concurrent chemoradiotherapy. A total of 134 patients treated with chemoradiotherapy for cervical cancer with pelvic and/or paraaortic lymph node metastasis (PALNM) were enrolled in this study. Clinical variables were investigated through review of the patients' medical records. The 5-year overall survival (OS) rate in patients with stage IIICr cervical cancer was 70.5%. Age, PALNM, parametrial invasion, T stage, pelvic side wall invasion, differentiation, lymphovascular space involvement and high squamous cell carcinoma antigen level (>8 ng/mL) were prognostic factors for survival. The 5-year OS rate of patients with stage IIIC1r was 74.5%, and that of stage IIIC2r was 38.1% (P-value = 0.012). The 5-year OS rate of patients with stage IIIC1r with the presence of pelvic side wall invasion was 48.3% and that in its absence was 83.0% (P-value < 0.001). The 5-year OS rate of patients with stage IIIC1r with the presence of parametrial invasion was 68.9% and that in its absence was 82.4% (P-value = 0.031). In multivariable analysis via backward conditional modeling, age, PALNM and pelvic side wall invasion were independent prognostic factors for survival of stage IIICr. Age and pelvic side wall invasion were independent prognostic factors for survival of stage IIIC1r cervical cancer. In stage IIICr cervical cancer, patients with PALNM, and/or pelvic side wall invasion can expect to have a poor prognosis. Particularly, pelvic side wall invasion in stage IIIC1r is an independent prognosis factor.

Preoperative SCC-Ag as a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors

BackgroundFor cervical cancer patients whose tumors display a combination of intermediate risk factors, postoperative radiation with or without adjuvant chemotherapy is suggested for them. However, who should be administered with adjuvant chemotherapy is unknown. The current study was designed to explore the clinical value of squamous cell carcinoma antigen (SCC-Ag) in guiding the use of adjuvant chemotherapy in cervical cancer patients.MethodsA total of 301 cervical cancer patients were included in the present study from March 2006 to March 2016. There were 156 patents who received adjuvant chemotherapy, while the rest of 145 patents did not receive it. The survival analysis including Overall survival (OS) and disease-free survival (DFS) was assessed by using the Kaplan-Meier method. Cox proportional hazards regression was done to detect factors in predicting the tumor prognosis.ResultsIn patients with high pre-treatment SCC-Ag level, those who received adjuvant chemotherapy acquired better prognosis than patients who did not receive it. Particularly, a lower rate of distant metastasis was found in the group of adjuvant chemo-radiotherapy than that in the group of adjuvant radiotherapy. As for patients with low pre-treatment SCC-Ag level, we observed no differences in both the OS and DFS between patients who were given and not given with adjuvant chemotherapy. In the multivariable analysis, adjuvant chemotherapy was significantly correlated with DFS and distant metastasis-free survival (DMFS) in patients with high SCC-Ag level.ConclusionPreoperative SCC-Ag can be a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors.

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.

Clinical Value of Tumor Marker Index Based on Preoperative CYFRA 21-1 and SCC-Ag in the Evaluation of Prognosis and Treatment Effectiveness in Patients with Esophageal Squamous Cell Carcinoma.

BackgroundThis study aimed to investigate the prognostic value of tumor marker index (TMI) based on preoperative cytokeratin 19 fragment (CYFRA 21–1) and squamous cell carcinoma antigen (SCC-Ag) and the relationship between preoperative TMI and treatment effectiveness of postoperative adjuvant chemotherapy for patients with esophageal squamous cell carcinoma (ESCC).Patients and MethodsBetween January 2009 and December 2014, a total of 267 patients with ESCC who underwent radical resection were retrospectively enrolled. The TMI was defined as the geometric mean of normalized CYFRA 21–1 and SCC-Ag levels. The clinical and prognostic values of TMI were determined using univariate and multivariate survival analyses.ResultsPreoperative TMI level was associated with age, tumor size, pT stage, pN stage, and CYFRA 21–1, SCC-Ag, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) levels. The 5-year overall survival rate of patients with high TMI was significantly lower than that of patients with low TMI (P < 0.001). Univariate and multivariate analyses revealed that TMI (P = 0.031) was an independent prognostic factor. Patients with ESCC with high TMI level who underwent surgery combined with postoperative chemotherapy had a significantly better prognosis than those who underwent surgery alone (P = 0.015). However, no significant difference was observed in patients with low TMI level (P = 0.682).ConclusionTMI as a prognostic indicator of ESCC is superior to CYFRA 21–1 and SCC-Ag. The TMI might be useful in predicting the therapeutic effectiveness of postoperative chemotherapy and selecting patients who may benefit from postoperative chemotherapy.

Prognostic significance of serum carcinoembryonic antigen and squamous cell carcinoma antigen in patients with esophageal squamous cell carcinoma undergoing radical esophagectomy.

BackgroundIt is generally believed that the preoperative serum carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC-Ag) levels are independent predictors of prognosis in multiple malignant tumors. However, their predictive value in esophageal squamous cell carcinoma (ESCC) is still unknown. Therefore, the main purpose of this study is to detect the serum CEA and SCC-Ag levels of ESCC patients before operation, in order to clarify the clinical significance of them as prognostic factors.MethodsWe conducted a retrospective review of 348 patients with ESCC treated by esophagectomy between February 2009 and October 2012. We Analyzed the influence of serum CEA and SCC-Ag level on prognosis. We used a receiver operating characteristic (ROC) curve to identify the serum CEA and SCC-Ag level for predicting survival. We used Log-rank test to compare survival curves, and Cox regression analysis to clarify significant prognostic factors.ResultsThe cutoffs for CEA and SCC-Ag were 2.28 ng/mL and 0.75 ng/mL, respectively, Under curve area of CEA was 0.600 (95% CI: 0.541–0.660; P=0.001) and under curve area of SCC-Ag was 0.567 (95% CI: 0.507–0.628; P=0.030). According to the Kaplan-Meier curves, the overall survival rate (OS) and disease-free survival rate (DFS) of patients with CEA ≤2.28 ng/mL were higher than those with CEA >2.28 ng/mL. Meanwhile, patients with serum levels of SCC-Ag ≤0.75 ng/mL had a more favorable OS and DFS than those of patients with SCC-Ag >0.75 ng/mL. Cox regression analysis showed that the total mortality of patients with CEA >2.28 ng/mL was higher than that of patients with CEA ≤2.28 ng/mL (HR 1.76; 95% CI: 1.39–2.39; P<0.001). Additionally, SCC-Ag >0.75 ng/mL was an independent negative prognostic factor for DFS (HR 1.86; 95% CI: 1.17–2.96; P=0.009). As the nomogram showed, the survival rate of ESCC patients with high preoperative serum CEA and SCC-Ag levels was relatively low.ConclusionsHigh levels of serum CEA and SCC-Ag were independent and significant predictors of ESCC patients after surgical treatment.

Coordination of Nanoconjugation with an Antigen/Antibody for Efficient Detection of Gynecological Tumors

Cervical, ovarian, and endometrial cancers are common in the female reproductive system. Cervical cancer starts from the cervix, while ovarian cancer develops when abnormal cells grow in the ovary. Endometrial or uterine cancer starts from the lining of the womb in the endometrium. Approximately 12,000 women are affected every year by cervical cancer in the United States. Squamous cell carcinoma antigen (SCC-Ag) is a well-established biomarker in serum for diagnosing gynecological cancers, and its levels were observed to be elevated in cervical, ovarian, and endometrial cancer patients. Moreover, SCC-Ag was used to identify the tumor size and progression stages. Various biosensing systems have been proposed to identify SCC-Ag; herein, enhanced interdigitated electrode sensing is presented with the use of gold nanoparticles (GNPs) to conjugate an antigen/antibody. It was proved that the limit of detection is 62.5 fM in the case of antibody-GNP, which is 2-fold higher than that by SCC-Ag-GNP. Furthermore, the antibody-GNP-modified surface displays greater current increases with concomitant dose-dependent SCC-Ag levels. High analytical performance was shown by the discrimination against α-fetoprotein and CYFRA 21-1 at 1 pM. An enhanced sensing system is established for gynecological tumors, representing an advance from the earlier detection methods.

Can serial evaluation of serum SCC-Ag-level predict tumor recurrence and patient survival in squamous-cell carcinoma of uterine cervix treated with definitive chemoradiotherapy? A multi-institutional analysis.

Tumor marker screening may be useful to evaluate tumor response and detect tumor recurrence. However, usefulness and cut-off value of squamous-cell carcinoma antigen (SCC-Ag) for recurrence and survival has not yet established in cervical cancer. From January 2010 to October 2016, 304 patients with cervical squamous-cell carcinomas with FIGO stage IB-IVA who underwent curative chemoradiotherapy followed by brachytherapy at four institutions were included in this study. Serum SCC-Ag level was measured before treatment, re-measured after completion of treatment, and again at the time of relapse during follow-up. SCC-Ag levels at each measurement point were analyzed using receiver operating characteristic (ROC) curve. Their associations with recurrence-free survival (RFS) and overall survival (OS) were analyzed. During a median follow-up time of 36.5months, there were 66 (21.7%) recurrences and 76 (25.0%) deaths. The ROC curve showed optimal Youden indices were 4, 1.5, and 4ng/mL at pretreatment, treatment, and recurrence, respectively. In patients with SCC-Ag ≥ 4ng/mL, not SCC-Ag < 4ng/mL before treatment, post-treatment SCC-Ag level (≥ 1.5ng/mL vs. < 1.5ng/mL) showed significant differences in 3-year RFS (65.5% vs. 45.0%, p < 0.001) and OS (78.5% vs. 55.4%, p < 0.001). In 66 recurrent patients, patients with SCC-Ag ≥ 4ng/mL at recurrence showed a significantly lower OS rate than others (59.5% vs. 33.0%, p = 0.041). SCC-Ag level after treatment and at recurrence was useful for predicting recurrence and survival only when its pretreatment value was high (≥ 4ng/mL).

Who can benefit from a lymph node boost in definitive chemoradiotherapy for node-positive cervical cancer: an evaluation of nodal failure in patients without nodal boost.

This study was performed to identify risk factors for pelvic nodal failure (PNF) after definitive concurrent chemo-radiotherapy (CCRT) in patients with metastatic pelvic lymph nodes (mPLNs) from squamous cell carcinoma (SCC) of the cervix. We retrospectively reviewed data on 80 patients who received definitive CCRT between 2005 and 2014 at our hospital. All patients underwent brachytherapy and whole-pelvic radiotherapy (WPRT) without nodal boost. mPLNs was diagnosed by magnetic resonance imaging and positron emission tomography. The rate of PNF and factors affecting PNF were analysed. A total of 156 mPLNs were found. The median number of mPLNs was 2 per patient (range 1–6); the median short diameter was 1.7 cm (range 1.0–4.2 cm). After a median follow-up of 64 months, 10 (6.4%) mPLNs failed in 13 (16.3%) patients. The 5-year PNF-free survival (PNFFS), disease-free survival and overall survival rates were 83.4, 62.7 and 74.7%, respectively. The mPLN size was not associated with the risk of PNF. However, pre-radiotherapy SCC antigen (SCC-Ag) >6.8 ng/mL and number of mPLNs >2 were significant risk factors for PNF. Using the two risk factors, we categorized the patients into three risk groups. The 5-year PNFFS rates in patients with 0, 1 and 2 risk factors were 100.0, 78.3 and 44.4%, respectively (P < 0.01). SCC-Ag level and number of mPLNs were significant factors for PNF. Patients with both risk factors developed frequent PNF after WPRT without nodal boost. The two risk factors can be a guide in deciding whether to administer nodal boost radiotherapy.

A Comparative Study of the Diagnostic and Prognostic Value of Squamous Cell Carcinoma Antigen and Alfa-foeto Protien in Hepatocellular Carcinoma Before and After Therapeutic Intervention

Abstract Background hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients. Aim of the Work was to verify the possibility of using the plasma squamous cell carcinoma antigen level as a tumor marker for hepatocellular carcinoma and to evaluate its prognostic value in management of HCC. Patients and Methods the study included 60 subjects divided into three groups: group I was 30 patients with hepatocellular carcinomas, group II was 15 patients with liver cirrhosis and group III was 15 normal subjects serving as a control group. Follow up of the patients who had HCC and undergone either RFA or TACE will be done after 1 month by measuring serum level of alfa feto protein &amp; SCCA. Results the plasma SCCA level was significantly higher in group I patients (with HCC), than in the group II patients (cirrhosis) and control group. SCCA showed direct significant correlation with the most of laboratory data specially AST, INR, number and size of lesion and its values were decreased after intervention. Conclusion plasma SCCA is a sensitive and specific serum marker for the diagnosis and prognosis of HCC and combination of AFP and SCCA in screening and diagnosis of HCC yielded a better sensitivity in diagnosis of HCC.

Efficacy and prognostic factors of concurrent chemoradiotherapy in patients with stage Ib3 and IIa2 cervical cancer.

We investigated the efficacy, side effects, and prognostic factors of concurrent chemoradiotherapy for patients with stage Ib3-IIa2 cervical cancer. We conducted a retrospective analysis of clinicopathologic data from 73 patients with stage Ib3-IIa2 cervical cancer who received concurrent chemoradiotherapy from January 2008 to December 2013 in our hospital. Overall response and disease control rates were used to evaluate short-term outcomes; the 3-year and 5-year disease-free survival and overall survival were used to evaluate long-term efficacy. Toxicity reactions and prognostic factors were recorded. With concurrent chemoradiotherapy, overall response and disease control rates were 91.78% and 97.26%, respectively. The 3-year disease-free and overall survival were 80.82% and 83.56%; the 5-year disease-free and overall survival were 75.34% and 79.45%, respectively. All side effects were tolerated and potentially alleviated by symptomatic treatment. Tumor pathological type, differentiated degree, primary tumor size and squamous cell carcinoma antigen levels before and after treatment were closely related to survival (univariate analysis; p < 0.05). Pathological type, primary tumor size and squamous cell carcinoma antigen levels one month after treatment were independent prognostic factors for long-term outcome (multivariate analysis). Short- and long-term efficacy of concurrent chemoradiotherapy for stage Ib3-IIa2 cervical cancer is well-determined and tolerable. Patients with adenocarcinomas, tumor diameter ≥ 5 cm and squamous cell carcinoma antigen levels ≥ 1.5 ng/mL (one month after treatment) had poor prognosis and should be assessed further.

The kinetic profile and clinical implication of SCC-Ag in squamous cervical cancer patients undergoing radical hysterectomy using the Simoa assay: a prospective observational study

BackgroundTo study the kinetic profile and clinicopathological implications of squamous cell carcinoma antigen (SCC-Ag) in cervical cancer patients who underwent surgery by a self-developed SCC-Ag single molecule assay (Simoa) prototype immunoassay.MethodsParticipants were prospectively enrolled between 04/2016 and 06/2017. Consecutive serum samples were collected at five points: day 0 (the day before surgery), postoperative day 4, weeks 2–4, months 2–4 and months 5–7. In total, 92 patients and 352 samples were included. The kinetic change in SCC-Ag levels and their associations with clinicopathological characteristics were studied.ResultsSimoa SCC-Ag was validated by comparison with the Architect assay. SCC-Ag levels measured by the Simoa assay were highly correlated with the Architect assay’s levels (Pearson’s correlation coefficient = 0.979, Passing-Bablok regression slope 0.894 (0.847 to 0.949), intercept − 0.009 (− 0.047 to 0.027)). The median values for each time-point detected by the Simoa assay were 2.49, 0.66, 0.61, 0.72, and 0.71 ng/mL, respectively. The SCC-Ag levels decreased dramatically after surgery and then stabilized and fluctuated to some extent within 6 months. Patients with certain risk factors had significantly higher SCC-Ag values than their negative counterparts before surgery and at earlier time points after surgery, while no difference existed at the end of observation. Furthermore, although patients with positive lymph nodes had sustained higher SCC-Ag levels compared to those with negative lymph nodes, similar kinetic patterns of SCC-Ag levels were observed after surgery. Patients who received postoperative treatment had significantly higher SCC-Ag values than those with surgery only at diagnosis, while no difference existed after treatment.ConclusionsThe Simoa SCC-Ag prototype was established for clinical settings. The SCC-Ag levels were higher in patients with risk factors, whereas the kinetic trend of SCC-Ag might be mainly affected by postoperative adjuvant therapy. These data indicate that the SCC-Ag level might be a good predictor for the status of cervical cancer, including disease aggressiveness and treatment response.

Prognosis-Predicting Model Based on [18F]fluorodeoxyglucose PET Metabolic Parameters in Locally Advanced Cervical Cancer Patients Treated with Concurrent Chemoradiotherapy: Multi-Center Retrospective Study.

This study aimed to develop a prognosis-predicting model based on [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and clinicopathologic factors in locally advanced cervical cancer patients treated with concurrent chemoradiotherapy (CCRT). The medical records of 270 locally advanced cervical cancer patients who were treated with CCRT were collected from three institutions and reviewed retrospectively. A nomogram was used for predicting 2-year disease-free survival (DFS) and 5-year overall survival (OS) based on Cox proportional hazards regression. Predictor variables included nodal maximum standardized uptake value (SUVmax), primary tumor SUVmax, age, tumor size, stage, serum squamous cell carcinoma antigen level, and human papillomavirus status. Internal nomogram validation was performed. A nomogram for predicting the 2-year DFS and 5-year OS was constructed using six and seven parameters, respectively. With a focus on 2-year DFS, our model found nodal SUVmax to be the highest weighted negative prognostic factor. With a focus on 5-year OS, young age was the highest weighted negative prognostic factor. The concordance index was 0.75 and 0.78 for the 2-year DFS and 5-year OS, respectively. This nomogram is a predictive tool that can be used to counsel patients for predicting survival outcomes. Moreover, our prognosis-predicting model may make it possible to personalize treatment.

Time-Dependent Squamous Cell Carcinoma Antigen in Prediction of Relapse and Death of Patients With Cervical Cancer.

The aim of the study was to develop a methodology to identify the best use of a longitudinally measured biomarker in relevance to prognosis. Data of squamous cell carcinoma antigen (SCC-Ag) from 770 patients with cervical squamous cell carcinoma (SCC) were used. The pretreatment, nadir, and time-dependent SCC-Ag values were analyzed in relevance to disease relapse and death with univariate and multivariate analysis side by side with a variety of available clinicopathologic factors. The predictive power of the significant variates was evaluated by C-index with 5-fold cross validation. The pretreatment, nadir, and time-dependent SCC-Ag were all significant risk factors for both relapse and death in the univariate analysis (p < .05), and the time-dependent SCC-Ag had the highest C-index in both events. The nadir and time-dependent SCC-Ag were both independently significant in response to relapse with International Federation of Gynecology and Obstetrics (FIGO) stage as the covariate, and the latter had a higher C-index (0.745). Only the time-dependent SCC-Ag was independently significant together with FIGO stage in response to death with the C-index at 0.844. Increases in the serum level of SCC-Ag in cervical SCC patients suggest a higher risk of both relapse and death. The best use of serial SCC-Ag measurements is to include the time-dependent value in prognostic assessment with FIGO stage also accounted for. Cervical SCC patients should be followed up on their levels of SCC-Ag, and prognostic evaluation should be updated with recent measurements.