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目的探讨治疗前血清鳞状细胞癌抗原(sCCAg)滴度与宫颈鳞状细胞癌(鳞癌)临床病理特征的关系,以及作为预测预后的因素的意义。方法选择114例治疗前检测过血清 SCCAg 并经治疗后长期随访的Ⅰ b1～Ⅱa期宫颈鳞癌患者,结合临床资料对 SCCAg 与临床病理特征及预后的关系进行单因素和多因素分析。结果单因素分析显示,治疗前血清 SCCAg 滴度升高(正常值≤1.5mg/L)与肿瘤直径、深肌层浸润及盆腔淋巴结转移相关(P<0.05);多因素分析显示,SCCAg 滴度升高与深肌层浸润(P=0.029)、盆腔淋巴结转移(P=0.049)相关。114例患者的5年累积无瘤生存率为78.6%,总复发率为27.2%。单因素分析显示,SCCAg 滴度升高、盆腔淋巴结转移与5年累积无瘤生存率及复发相关(P<0.05);多因素分析显示,影响预后的独立因素为 SCCAg 滴度升高(P=0.030)和盆腔淋巴结转移(P=0.003),影响复发的显著相关因素为盆腔淋巴结转移(P=0.006)。盆腔淋巴结转移且 SCCAg 滴度正常者与盆腔淋巴结转移且 SCCAg 滴度升高者,5年累积无瘤生存率(分别为50.0%、50.9%)、复发率[分别为60.0%(6/10)、47.1%(8/17)]、局部复发率[分别为3/8、20.0%(3/15)]和远处复发率[分别为1/8、20.0%(3/15)]分别比较,差异均无统计学意义(P>0.05)。盆腔淋巴结无转移且 SCCAg 滴度正常者与盆腔淋巴结无转移且 SCCAg 滴度升高者,5年累积无瘤生存率(分别为98.0%、71.8%,P=0.003)、复发率[分别为9.8%(5/51)、33.3%(12/36),P=0.006]、局部复发率[分别为2.1%(1/47)、26.5%(9/34),P=0.001]分别比较,差异均有统计学意义。结论治疗前血清 SCCAg 滴度升高和盆腔淋巴结转移是影响Ⅰb1～Ⅱa期宫颈鳞癌患者预后的独立因素。治疗前血清 SCCAg 滴度升高且盆腔淋巴结无转移患者的局部复发风险显著升高。
Objective To investigate the relationship between serum sSCAg titer and clinicopathological features of squamous cell carcinoma (squamous cell carcinoma) before treatment and their significance as predictors of prognosis. Methods A total of 114 patients with cervical squamous cell carcinoma of stage Ⅰ b1 ~ Ⅱa who had been tested for serum SCCAg before treatment and were followed up for a long time were selected. The relationship between SCCAg and clinicopathological features and prognosis was analyzed by univariate and multivariate analysis. Results Univariate analysis showed that pretreatment serum SCCAg titer (normal≤1.5mg / L) was correlated with tumor diameter, deep myometrial invasion and pelvic lymph node metastasis (P <0.05). Multivariate analysis showed that SCCAg titer Elevation was associated with deep myometrial invasion (P = 0.029) and pelvic lymph node metastasis (P = 0.049). The 5-year cumulative tumor-free survival rate was 78.6% in 114 patients, with a total recurrence rate of 27.2%. Univariate analysis showed that SCCAg titer and pelvic lymph node metastasis were associated with 5-year cumulative tumor-free survival rate and relapse (P <0.05). Multivariate analysis showed that SCCAg titer increased independently (P = 0.030) and pelvic lymph node metastasis (P = 0.003). The most significant correlation was the pelvic lymph node metastasis (P = 0.006). The 5-year cumulative 5-year disease-free survival rates (50.0% and 50.9%, respectively) and recurrence rates were 60.0% (6/10, respectively) in patients with pelvic lymph node metastasis, normal SCCAg titer and pelvic lymph node metastasis with high SCCAg titer , 47.1% (8/17)], local recurrence rates [3/8, 20.0% (3/15)] and distant recurrence rates [1/8, 20.0% (3/15), respectively] , There was no significant difference (P> 0.05). The 5-year cumulative tumor-free survival rates were 98.0%, 71.8%, respectively, P = 0.003), and the relapse rates were 9.8% (9.8%, respectively) in patients with normal pelvic lymph node metastasis, normal SCCAg titer and no pelvic lymph node metastasis. (5/51), 33.3% (12/36), P = 0.006]. The local recurrence rates were 2.1% (1/47), 26.5% (9/34), P = 0.001] All have statistical significance. Conclusion Pretreatment serum SCCAg titer and pelvic lymph node metastasis is an independent factor affecting the prognosis of patients with stage Ⅰ 1b ~ Ⅱa cervical squamous cell carcinoma. Patients with elevated serum SCCAg titer and a significantly higher risk of local recurrence in patients with pelvic lymph node metastasis before treatment.