Korean J Obstet Gynecol.  2011 Aug;54(8):428-434. 10.5468/KJOG.2011.54.8.428.

Prognostic value of pre-treatment SCC-Ag level in patients with cervical cancer

• An JJ
• Lee YY
• Park JY
• Choi CH
• Kim TJ
• Lee JW
• Kim BG
• Bae DS

• KMID: 2274062
• DOI: http://doi.org/10.5468/KJOG.2011.54.8.428

Abstract

OBJECTIVE
The purpose of this study is to investigate the prognostic role of pre-treatment squamous cell carcinoma-related antigen (SCC-Ag) level in patients with squamous cell carcinoma of the uterine cervix.
METHODS
In this study, we retrospectively enrolled patients with squamous cell carcinoma of the uterine cervix (FIGO stage IB to IVA) who were treated at Samsung Medical Center, Seoul, Korea, from 1996 to 2007.
RESULTS
We retrospectively enrolled 788 patients. Median SCC-Ag level was 1.6 ng/mL (reference range, 0.1-362.0) in all patients. Four hundred seven out of 788 patients had elevating pre-treatment SCC-Ag level (51.6%). When we divided the cohort based on the stage (early cervical carcinoma; IB1 and IIA vs. locally advanced cervical carcinoma [LACC]; IB2 and IIB to IVA) and performed multivariate analysis, pre-treatment SCC-Ag entailed prognostic significance only in LACC (progression-free survival: hazard ratio [HR], 1.007; 95% confidential interval [CI], 1.003-1.010; overall survival: HR, 1.005; 95% CI, 1.001-1.009). Among patients who showed recurrence disease and had the result of SCC-Ag before recurrence (n=94), 79 patients (84.0%) had the elevation of SCC-Ag level at the time of recurrence.
CONCLUSION
Pre-treatment SCC-Ag level is an independent prognostic factor for survival in patients with LACC. Measuring pre-treatment serum SCC-Ag may be a cost-effective method to predict prognosis in patients with LACC.

Keyword

Squamous cell carcinoma-related antigen; TA-4; Uterine cervical neoplasms; Prognostic; Survival

MeSH Terms

Antigens, Neoplasm
Carcinoma, Squamous Cell
Cervix Uteri
Cohort Studies
Female
Humans
Korea
Multivariate Analysis
Prognosis
Recurrence
Retrospective Studies
Serpins
Uterine Cervical Neoplasms
Antigens, Neoplasm
Serpins

Figure

• 

  Fig. 1 Progression-free survival and overall survival according to the squamous cell carcinoma-related antigen level (high vs. low) in patients with locally advanced cervical carcinoma.

Reference

1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. 2010. cited 2011 Jul 20. Lyon, France: International Agency for Research on Cancer;Available from: http://globocan.iarc.fr.

2. Garcia M, Jemal A, Ward EM, Center MM, Hao Y, Siegel RL, et al. Global cancer facts & figures 2007 [Internet]. 2007. cited 2008 Aug 22. Atlanta (GA): American Cancer Society;Abailable from: http://www.cancer.org/acs/groups/content/@nho/documents/document/globalfactsandfigures2007rev2p.pdf.

3. Berek JS, Novak E. Berek & Novak's gynecology. 2007. 14th ed. Philadelphia (PA): Lippincott Williams & Wilkins.

4. Gien LT, Beauchemin MC, Thomas G. Adenocarcinoma: a unique cervical cancer. Gynecol Oncol. 2010. 116:140–146.

5. Davelaar EM, van de Lande J, von Mensdorff-Pouilly S, Blankenstein MA, Verheijen RH, Kenemans P. A combination of serum tumor markers identifies high-risk patients with early-stage squamous cervical cancer. Tumour Biol. 2008. 29:9–17.

6. Maruo T, Yoshida S, Samoto T, Tateiwa Y, Peng X, Takeuchi S, et al. Factors regulating SCC antigen expression in squamous cell carcinoma of the uterine cervix. Tumour Biol. 1998. 19:494–504.

7. Pras E, Willemse PH, Canrinus AA, de Bruijn HW, Sluiter WJ, ten Hoor KA, et al. Serum squamous cell carcinoma antigen and CYFRA 21-1 in cervical cancer treatment. Int J Radiat Oncol Biol Phys. 2002. 52:23–32.

8. Gadducci A, Tana R, Cosio S, Genazzani AR. The serum assay of tumour markers in the prognostic evaluation, treatment monitoring and follow-up of patients with cervical cancer: a review of the literature. Crit Rev Oncol Hematol. 2008. 66:10–20.

9. Reesink-Peters N, van der Velden J, Ten Hoor KA, Boezen HM, de Vries EG, Schilthuis MS, et al. Preoperative serum squamous cell carcinoma antigen levels in clinical decision making for patients with early-stage cervical cancer. J Clin Oncol. 2005. 23:1455–1462.

10. Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999. 340:1144–1153.

11. Peters WA 3rd, Liu PY, Barrett RJ 2nd, Stock RJ, Monk BJ, Berek JS, et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol. 2000. 18:1606–1613.

12. Choi CH, Lee YY, Kim MK, Kim TJ, Lee JW, Nam HR, et al. A Matched-Case Comparison to Explore the Role of Consolidation Chemotherapy After Concurrent Chemoradiation in Cervical Cancer. Int J Radiat Oncol Biol Phys. 2010. 11. 13. [Epub]. DOI: 10.1016/j.ijrobp.2010.07.2006.

13. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009. 105:103–104.

14. Kidd EA, Siegel BA, Dehdashti F, Rader JS, Mutch DG, Powell MA, et al. Lymph node staging by positron emission tomography in cervical cancer: relationship to prognosis. J Clin Oncol. 2010. 28:2108–2113.

15. Kato H, Torigoe T. Radioimmunoassay for tumor antigen of human cervical squamous cell carcinoma. Cancer. 1977. 40:1621–1628.

16. Gadducci A, Tana R, Fanucchi A, Genazzani AR. Biochemical prognostic factors and risk of relapses in patients with cervical cancer. Gynecol Oncol. 2007. 107:S23–S26.

17. van de Lande J, Davelaar EM, von Mensdorff-Pouilly S, Water TJ, Berkhof J, van Baal WM, et al. SCC-Ag, lymph node metastases and sentinel node procedure in early stage squamous cell cervical cancer. Gynecol Oncol. 2009. 112:119–125.

18. Gaarenstroom KN, Bonfrer JM, Kenter GG, Korse CM, Hart AA, Trimbos JB, et al. Clinical value of pretreatment serum Cyfra 21-1, tissue polypeptide antigen, and squamous cell carcinoma antigen levels in patients with cervical cancer. Cancer. 1995. 76:807–813.

19. Takeda M, Sakuragi N, Okamoto K, Todo Y, Minobe S, Nomura E, et al. Preoperative serum SCC, CA125, and CA19-9 levels and lymph node status in squamous cell carcinoma of the uterine cervix. Acta Obstet Gynecol Scand. 2002. 81:451–457.

20. Hong JH, Tsai CS, Lai CH, Chang TC, Wang CC, Chou HH, et al. Risk stratification of patients with advanced squamous cell carcinoma of cervix treated by radiotherapy alone. Int J Radiat Oncol Biol Phys. 2005. 63:492–499.

21. Hong JH, Tsai CS, Chang JT, Wang CC, Lai CH, Lee SP, et al. The prognostic significance of pre- and posttreatment SCC levels in patients with squamous cell carcinoma of the cervix treated by radiotherapy. Int J Radiat Oncol Biol Phys. 1998. 41:823–830.

22. Ferrandina G, Macchia G, Legge F, Deodato F, Forni F, Digesù C, et al. Squamous cell carcinoma antigen in patients with locally advanced cervical carcinoma undergoing preoperative radiochemotherapy: association with pathological response to treatment and clinical outcome. Oncology. 2008. 74:42–49.

23. Yalman D, Aras AB, Ozkok S, Duransoy A, Celik OK, Ozsaran Z, et al. Prognostic factors in definitive radiotherapy of uterine cervical cancer. Eur J Gynaecol Oncol. 2003. 24:309–314.

24. Torre GC. SCC antigen in malignant and nonmalignant squamous lesions. Tumour Biol. 1998. 19:517–526.

25. Lomnytska MI, Becker S, Bodin I, Olsson A, Hellman K, Hellström AC, et al. Differential expression of ANXA6, HSP27, PRDX2, NCF2, and TPM4 during uterine cervix carcinogenesis: diagnostic and prognostic value. Br J Cancer. 2011. 104:110–119.

26. Min L, Dong-Xiang S, Xiao-Tong G, Ting G, Xiao-Dong C. Clinicopathological and prognostic significance of Bmi-1 expression in human cervical cancer. Acta Obstet Gynecol Scand. 2011. 90:737–745.

27. Porika M, Tippani R, Mohammad A, Bollam SR, Panuganti SD, Abbagani S. Evaluation of serum human telomerase reverse transcriptase as a novel marker for cervical cancer. Int J Biol Markers. 2011. 26:22–26.