血清鳞状细胞癌抗原在宫颈鳞癌中的临床价值  

Clinical value of serum squamous cell carcinoma antigen in cervical squamous cell carcinoma

作　　者：潘含义 陈泓[2] PAN Hanyi;CHEN Hong(Department of Gynecology,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Department of Gynecology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530022,Guangxi,China)

机构地区：[1]右江民族医学院附属医院妇科,广西百色533000 [2]广西医科大学第一附属医院妇科,广西南宁530022

出　　处：《右江医学》2022年第9期681-685,共5页Chinese Youjiang Medical Journal

基　　金：百色市科学研究与技术开发计划课题(百科20213241)。

摘　　要：目的 探讨血清鳞状细胞癌抗原(SCCA)在宫颈鳞癌2018年国际妇产科联盟(FIGO)分期标准中的诊断价值及其与临床病理特征关系。方法 收集2012年5月至2018年12月期间在广西医科大学第一附属医院就诊满足条件的宫颈鳞癌患者727例,采用2018年FIGO分期标准分为Ⅰ、Ⅱ、Ⅲ、Ⅳ期,以及同期经子宫颈锥切组织学确诊的宫颈上皮内瘤变Ⅲ级(CINⅢ)患者106例作为对照组。采用化学发光免疫法检测患者治疗前血清SCCA的水平,探讨血清SCCA对宫颈鳞癌的诊断价值。进一步分析407例初治治疗为子宫颈根治术+盆腔/腹主淋巴结清扫术的早期宫颈鳞癌患者,治疗前血清SCCA<1.1 ng/mL和SCCA≥1.1 ng/mL的两组病例与临床病理特征关系及相关影响因素。结果 (1)宫颈鳞癌组血清SCCA水平高于CINⅢ组,差异有统计学意义(P<0.001)。(2)当血清SCCA取1.1 ng/mL为界值时,单因素分析显示:两组患者在肿瘤大小、2018年FIGO分期、浸润深度、脉管浸润、淋巴结转移上比较差异有统计学意义(P<0.05)。多因素分析结果显示:FIGO分期、肿瘤大小、浸润深度是宫颈鳞癌患者SCCA的独立影响因素(P<0.05)。结论 (1)宫颈鳞癌患者中检测血清肿瘤标志物SCCA水平可作为癌前病变与癌诊断的辅助检查,特异性好,最佳截断值为1.1 ng/mL。(2)2018年FIGO分期、肿瘤大小、浸润深度是宫颈鳞癌患者SCCA的独立影响因素。Objective To investigate the diagnostic value of serum squamous cell carcinoma antigen(SCCA) in 2018 International Federation of Gynecology and Obstetrics(FIGO) staging standards of cervical squamous cell carcinoma and its relationship with clinicopathological features. Methods 727 patients with cervical squamous cell carcinoma who met the selection criteria in the First Affiliated Hospital of Guangxi Medical University from May 2012 to December 2018 were selected as the study group and were divided into stages Ⅰ, Ⅱ, Ⅲ and Ⅳ according to 2018 FIGO staging standards;and 106 patients with cervical intraepithelial neoplasia grade Ⅲ(CIN Ⅲ) histologically diagnosed by cervical conization in the same period were selected as the control group. The level of serum SCCA was detected by chemiluminescence immunoassay before treatment to investigate the diagnostic value of serum SCCA in cervical squamous cell carcinoma. The relationship between the levels of serum SCCA<1.1 ng/mL and serum SCCA≥1.1 ng/mL before treatment of 407 patients with early cervical squamous cell carcinoma initially treated with radical hysterectomy and pelvic/abdominal lymph node dissection and their clinicopathological features and related influencing factors were further analyzed. Results (1) The serum SCCA level of the study group(patients with cervical squamous cell carcinoma) was higher than that of control group(CIN Ⅲ), which was statistically significantly different(P<0.001).(2) When the level of serum SCCA was 1.1 ng/mL as cut-off point, univariate analysis showed that there were significant differences in tumor size, 2018 FIGO staging, depth of invasion, vascular invasion and lymph node metastasis between the two groups(P<0.05). Multivariate analysis showed that FIGO staging, tumor size, and depth of invasion were independent influencing factors of SCCA in patients with cervical squamous cell carcinoma(P<0.05). Conclusion (1) Detection of SCCA level, the serum tumor marker, in patients with cervical squamous cell carcinoma can

关 键 词：鳞状细胞癌抗原 宫颈鳞癌 诊断 临床特征 

分 类 号：R737.3[医药卫生—肿瘤]