血清鳞状细胞癌抗原在宫颈鳞癌分期中的临床价值  

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

作　　者：潘含义 陈泓[2] 李有幸 钟丽丽 Pan Hanyi;Chen Hong;Li Youxing;Zhong Lili(Department of Gynecology,The 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;Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;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 [3]右江民族医学院,广西百色533000 [4]广西医科大学,广西南宁530022

出　　处：《右江民族医学院学报》2023年第3期472-476,481,共6页Journal of Youjiang Medical University for Nationalities

基　　金：百色市科学研究与技术开发计划课题(百科20213241);广西科技计划项目(桂科AB18126043)。

摘　　要：目的探讨血清鳞状细胞癌抗原(SCCA)定量检测在宫颈鳞癌FIGO 2009年、2018年分期中的临床价值。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的727例宫颈鳞癌患者血清标本,化学发光免疫法检测治疗前SCCA的表达量,根据国际妇产科联盟(FIGO)2009年和2018年分期标准统计不同分期之间血清SCCA定量并进行统计学分析比较。结果①无论是在2009年分期还是在2018年分期中,Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期各期别血清SCCA表达量差异有统计学意义(P<0.001)。在2009年分期中,Ⅰ期和Ⅱ期、Ⅲ期、Ⅳ期,Ⅱ期和Ⅲ期、Ⅳ期表达量的差异具有统计学意义(P<0.05),Ⅲ期和Ⅳ期表达量无差异(P>0.05)。在2018年分期中,Ⅰ期和Ⅱ期、Ⅲ期、Ⅳ期,Ⅱ期和Ⅳ期的SCCA表达差异具有统计学意义(P<0.05),Ⅲ期和Ⅳ期表达量有差异(P<0.05),Ⅱ期和Ⅲ期表达量无差异(P>0.05)。Ⅱ期和ⅢA+ⅢB期,ⅢA+ⅢB期和ⅢC(ⅢCr+ⅢCp)期SCCA表达量存在差异(P<0.001),而Ⅱ期和ⅢC(ⅢCr+ⅢCp)期、Ⅱ期和ⅢC1p期、Ⅱ期和ⅢCr(ⅢC1r+ⅢC2r)期的SCCA表达量无差异(P>0.05)。②以SCCA>2.2 ng/mL作为临界值时,2009年FIGO分期中诊断为Ⅱ期的敏感度和特异度分别为62.82%、66.67%。③以SCCA>2.2 ng/mL作为临界值时,2018年FIGO分期中诊断为Ⅱ期的敏感度和特异度分别为63.32%、71.95%。结论血清SCCA表达量和FIGO 2009年和2018年分期有关。无论是影像学还是病理学盆腹主淋巴结转移均与SCCA表达量无关。Objective To explore the clinical value of quantitative detection of serum squamous cell carcinoma antigen(SCCA)in the 2009 and 2018 FIGO staging of cervical squamous cell carcinoma.Methods This study collected serum specimens from 727 patients with cervical squamous cell carcinoma treated in the First Affiliated Hospital of Guangxi Medical University from May 2012 to December 2018.We detected the expression of SCCA before treatment by chemiluminescence immunoassay.According to the International Federation of Gynecology and Obstetrics(FIGO)staging criteria in 2009 and 2018,the patients’serum SCCA in different sages was quantified and compared through statistical analysis.Results①In both 2009 and 2018 staging,there were significant differences in serum SCCA expressions among stagesⅠ,Ⅱ,ⅢandⅣ(P<0.001).In the 2009 staging,there were significant differences in serum SCCA expression between stageⅠand stagesⅡ,Ⅲ,Ⅳ,and between stageⅡand stagesⅢ,Ⅳ(P<0.05),but there was no significant difference in serum SCCA expression between stageⅢand stageⅣ(P>0.05).In the 2018 staging,there were significant differences in SCCA expression between stageⅠand stagesⅡ,Ⅲ,Ⅳ,and between stageⅡand stageⅣ(P<0.05).There was statistical difference between stageⅢand stageⅣ(P<0.05),but there was no significant difference between stageⅡand stageⅢ(P>0.05).There were significant differences in SCCA expression between stageⅡand stageⅢA+ⅢB,and between stageⅢA+ⅢB and stageⅢC(ⅢCr+ⅢCp)(P<0.001),but there was no significant difference in SCCA expression between stageⅡand stagesⅢC(ⅢCr+ⅢCp),ⅢC1p,ⅢCr(ⅢC1r+ⅢC2r)(P>0.05).②With SCCA>2.2 ng/mL as the threshold value,the sensitivity and specificity of stageⅡdiagnosis in the 2009 FIGO staging were 62.82%and 66.67%,respectively.③With SCCA>2.2 ng/mL as the threshold value,the sensitivity and specificity of stageⅡin the 2018 FIGO staging were 63.32%and 71.95%respectively.Conclusion Serum SCCA expression is correlated with the 2009 a

关 键 词：癌 鳞状细胞 抗原 宫颈肿瘤 分期 

分 类 号：R711.74[医药卫生—妇产科学]