血清鳞状细胞癌抗原检测对宫颈鳞状细胞癌诊断和预后评价的价值  

Clinical Value of Serum SCC-Ag in the Diagnosis and Prognosis of Squamous Cell Carcinoma in Uterine Cervix

作　　者：朱彦玲[1] 王新霞[1] 章文华[2] 张红[1] 张杰[1] 张萍[1] 王岚[1] 

机构地区：[1]江苏省徐州市肿瘤医院妇瘤科,江苏徐州221000 [2]中国医学科学院北京协和医学院肿瘤医院妇瘤科,北京100021

出　　处：《医学临床研究》2013年第3期419-422,共4页Journal of Clinical Research

基　　金：江苏省徐州市科委立项资助课题（项目编号：XF11C082）

摘　　要：[目的]探讨血清鳞状细胞癌抗原（SCC—Ag）诊断宫颈宫颈鳞状细胞癌（SCC）的临床价值及治疗前SCC—Ag水平与SCC临床病理参数的关系。【方法】检测77例宫颈SCC患者治疗前及治疗后1个月、3个月的血清SCC—Ag及55例健康对照者血清SCC-Ag；比较宫颈SCC患者与健康对照者的血清SCC-Ag水平及阳性率。分析SCC—Ag水平与宫颈SCC临床分期、病理分级、淋巴结转移及局部肿瘤大小的关系。【结果】宫颈SCC患者治疗前血清SCC—Ag水平显著高于健康对照组，SCC-Ag诊断宫颈SCC的敏感度为83．1％，特异度为86．0％，准确性为84．2％。宫颈SCC治疗后1个月及3个月血清SCC—Ag水平较治疗前均显著下降（P〈O．01）。肿瘤临床分期晚、病理级别高、有淋巴结转移的宫颈scC患者治疗前血清SCC—Ag水平明显高于临床分期早、病理级别低、无淋巴结转移的患者（分别P〈0．01，P〈0．05，P〈0．01）。局部肿瘤直径≥4cm的患者血清SCC—Ag水平显著高于肿瘤直径〈4C1Tl的患者（P〈O．01）。【结论】血清SCC—Ag水平测定可辅助宫颈SCC的临床诊断并可作为预测肿瘤预后的指标之一；治疗前高SCC-Ag水平的患者预后差，应及时接受个体化的治疗。[Objective] To explore the clinical value of serum squamous cell carcinoma antigen（SCC-Ag） in the diagnosis of squamous cell carcinoma of uterine cervix and the correlation of pretreatment SCC-Ag with clinicopatho- logical features and tumor size of squamous cell carcinoma of uterine cervix. [Methods] Serum level of SCC-Ag was detected in 77 patients with squamous cell carcinoma of uterine cervix before and 1, 3 months after treatment and 55 healthy controls. Serum level and positive rate of SCC-Ag were compared between patients with squamous cell carci- noma of uterine cervix and healthy controls. The correlation of SCC-Ag with clinical stage, pathological grade, lymph node metastasis and tumor size was analyzed. [Results] Serum level of SCC-Ag in squamous cell carcinoma of uterine cervix before treatment was significantly higher than that in healthy controls. The sensitivity, specificity and accuracy of SCC-Ag for the diagnosis for cervical squamous cell carcinoma were 83. 1%, 86.0% and 84.2%, respectively. Compared with before treatment, serum level of SCC-Ag 1 and 3 months in squamous cell carcinoma of uterine cervix after treatment significantly decreased（ P d0. 01）. Serum level of SCC-Ag in patients with late clinical stage, high pathologic stage and lymph node metastasis was obviously higher than that in patients with early clinical stage, low pathologic stage and non-lymph node metastasis（ P d0.01, P d0.05 and P d0.01, respectively）. Serum SCC-Ag level in patients with tumor diameter more than 4cm was significantly higher than that in patients with tumor diameter low than 4cm（ P d0. 01）. [Conclusion] Serum level of SCC-Ag can be the assistance of clinical diagnosis of squa- mous cell carcinoma of uterine cervix and used as one of the indicators to predict the prognosis of carcinoma. Patients with high level of SCC-Ag before treatment have poor prognosis and should accept the individual treatment.

关 键 词：癌 鳞状细胞 宫颈肿瘤 预后 

分 类 号：R737.3[医药卫生—肿瘤]