Clninical Utility of Serum Squamous Cell Carcinoma Antigen and Urine Polyamines in Cervical Carcinoma

Kim, Young Tae; Mo, Hyung Jin; Kim, Jae Wook

Abstract

Polyamines are closely related to cell growth and differentiation and increased levels of urine polyamines (UPs) has been reported in various human cancers. However, there were few reports on changes of UPs in patients with cervical carcinoma. We investigated the clinical utility of UPs as well as serum squamous cell carcinoma (SCC) antigen in cervical carcinoma. The association of pretreatment SCC antigen and UPs with clinicopathologic parameters was assessed in 478 patients with cervical carcinoma. SCC antigen was measured by radioimmunoassay and UPs by enzymatic assay method. The prognostic significance of pretreatment SCC antigen and UPs, and the relationship between pretreatment and posttreatment SCC antigen and UPs according to treatment modalities were analyzed. There was a trend of increased level of UPs with cancer progression, whereas significant difference of SCC antigen value was found with cancer progression. Among various clinicopathologic parameters, tumor size and macroscopic lymph node metastasis were associated with pretreatment SCC antigen and UPs level as well. Increased pretreatment SCC antigen level (>2.0ng/ml) and UPs level (>45 micromol/g creatinine) had significant impact on survival. Multivariate analysis revealed that pretreatment SCC antigen, lymph node metastasis and tumor size were independent prognostic factors on survival in the same stage patients. SCC antigen levels decreased after radiotherapy and neoadjuvant chemotherapy. In patients treated by radiation, response status was associated with postradiation SCC antigen, which showed a good correlation with survivals. UPs positivity and SCC antigen positivity in 42 recurrent cervical cancers were 64.7% and 57.9%, respectively. Pretreatment SCC antigen, combination of SCC antigen and UPs, tumor size, macroscopic lymph node metastasis and invasion depth were correlated with recurrent or residual cervical carcinoma. In conclusion, UPs together with SCC antigen may be used to assess the extent of disease status and to define the prognosis in cervical carcinoma.