摘要
目的:探讨术前血清鳞状细胞癌抗原(SCC-Ag)水平对早期宫颈鳞癌患者淋巴结转移(LNM)的预测价值。方法:将162例接受手术治疗的早期宫颈鳞癌患者(FIGO 2009分期Ⅰb~Ⅱa)纳入研究。分析手术治疗前SCC-Ag水平与患者临床病理特征的关系及其对LNM的预测价值。结果:术前SCC-Ag水平升高与FIGO分期(P=0.001)、肿瘤直径>4cm(P<0.001)、间质浸润深度(P<0.001)、LNM(P<0.001)及淋巴血管间隙浸润(LVSI)有关(P=0.045),与年龄、组织分化程度、宫旁浸润及阴道切缘受累无关(均P>0.05)。单因素分析显示,LNM与分期(P=0.015)、肿瘤大小(P=0.044)、间质浸润深度(χ2=10.436,P=0.005)、SCC-Ag≥2.75ng/ml(χ2=14.339,P<0.001)、LVSI(χ2=12.866,P<0.001)、宫旁浸润(χ2=13.784,P<0.001)有关,而与年龄、组织分化程度及阴道切缘受累无关(均P>0.05)。多因素分析显示,SCC-Ag≥2.75ng/ml(P=0.011,OR=3.287)及LVSI(P=0.009,OR=7.559)是影响LNM的独立因素。SCC-Ag受试者工作特征曲线下面积(AUC)为0.703(P<0.001),SCC-Ag 2.75ng/ml为预测LNM的最佳截断值,此时诊断的敏感性为69.4%,特异性为65.9%。结论:术前SCC-Ag水平升高是宫颈鳞癌预后的独立危险因素。SCC-Ag≥2.75ng/ml可作为术前预测宫颈鳞癌LNM的有效指标。
Objective:To investigate the predictive value of preoperative serum squamous cell carcinoma antigen(SCC-Ag)level for lymph node metastasis(LNM)in patients with early-stage cervical squamous cell carcinoma who underwent radical surgery.Methods:A total of 162 patients with International Federation of Gynecology and Obstetrics(FIGO 2009)stages Ib toⅡa cervical squamous cell carcinoma who underwent radical surgery were enrolled in this study.Correlation of the SCC-Ag level before operation with clinicopathological features and the predictive value of SCC-Ag for LNM were analyzed.Results:High preoperative SCC-Ag level was related to FIGO stage(P=0.001),tumor size>4cm(P<0.001),stromal infiltration(P<0.001),LNM(P<0.001)and lymphovascular space invasion(LVSI)(P=0.045).It was not related to age,histological differentiation,parametrial involvement and positive vaginal margin(P>0.05).Univariate analysis showed that FIGO stage(P=0.015),tumor size(P=0.044),stromal infiltration(χ2=10.436,P=0.005),SCC-Ag≥2.75ng/ml(χ2=14.339,P<0.001),LVSI(χ2=12.866,P<0.001),parametrial involvement(χ2=13.784,P<0.001)were related to LNM,but not related to age,histological differentiation and positive vaginal margin.Multivariate analysis showed that SCC-Ag≥2.75ng/ml(P=0.011,OR=3.287)and LVSI(P=0.009,OR=7.559)were independent factors affecting LNM.The area under the receiver operator characteristic curve(AUC)of SCC-Ag was 0.703(P<0.001),SCC-Ag 2.75ng/ml was the best cut-off value for predicting LNM.The sensitivity and specificity of diagnosis were 69.4%and 65.9%,respectively.Conclusion:High SCC-Ag level was revealed to be an independent risk factor for the prognosis of squamous carcinoma of the cervix before an operation.SCC-Ag≥2.75ng/ml can be utilized as a effective marker to predict LNM in early stage cervical cancer before an operation.
作者
朱成功
姜继勇
张文清
王秀莹
焦澜舟
陈丽艳
Zhu Chenggong;Jiang Jiyong;Zhang Wenqing(Dalian Maternal and Child Health Care Hospital,Dalian 116033)
出处
《现代妇产科进展》
CSCD
北大核心
2020年第12期896-900,共5页
Progress in Obstetrics and Gynecology
关键词
宫颈鳞癌
鳞状细胞癌抗原
淋巴结转移
预测价值
Squamous carcinoma of the cervix
SCC-Ag
Lymph node metastasis
Predictive value
作者简介
第一作者:朱成功(1980-),男,大连市妇幼保健院副主任医师。主要研究方向:妇科肿瘤;通讯作者:姜继勇,Email:jjydl59@163.com。
