SCC-Ag对早期宫颈癌患者淋巴结转移评估的价值

目的:探讨鳞状细胞癌抗原（SCC-Ag）在早期宫颈癌患者淋巴结转移中的临床应用价值。方法:对2004年5 月至2008年12月天津市中心妇产科医院的110 例ⅠB～ⅡA 期宫颈鳞癌患者行术前血清SCC-Ag 检测，并结合其临床病理资料进行回顾性分析。对SCC-Ag 与相关临床病理参数的关系采用Mann-WhitneyU 检验和Logistic回归分析；绘制受试者工作特征（ROC ）曲线，确定评估淋巴结转移的SCC-Ag 阈值。结果:单因素分析显示，SCC-Ag 滴度与宫颈癌临床分期、肿瘤直径、肌层浸润深度和淋巴结转移有关，与分化程度及脉管内瘤栓无关；Logistic回归分析进一步提示肿瘤直径及淋巴结转移是影响血清SCC-Ag≥4ng/mL的独立危险因素，且淋巴结转移对SCC-Ag 的影响更大；ROC 曲线显示SCC-Ag 为4ng/mL 是筛选淋巴结转移的最佳界值。结论:术前血清SCC-Ag 在评估早期宫颈鳞癌淋巴结转移中有一定的价值，其临界值为4ng/mL。 

Significance of Preoperative Serum Squamous Cell Carcinoma Antigen on Lymphatic Metastasis in Early-Stage Cervical Cancer

Objective: To investigate the clinical significance of serum squamous cell carcinoma antigen (SCC-Ag) in lymphatic metastasis of early-stage cervical cancer. Methods:Preoperative serum SCC-Ag detection was conducted in110 patients with stage IB-IIA cervical squamous cell cancer (SCC) who were admitted to the Tianjin Central Hospital of Gyne-cology and Obstetrics during a period from May 2004to December 2008, and a retrospective study of the cases in combi? nation with the related clinico- pathologic data was carried out. The correlation between the clinico-pathologic findings and SCC-Ag outcomes was statistically analyzed using Mann-Whitney U test and multiple logistic regression analysis. The re-ceptor performance curve (ROC) of the cases was drawn to decide and evaluate the threshold value of SCC-Ag in lymph node metastasis. Results: Univariate analysis showed that SCC-Ag titre correlates significantly with the FIGO staging, tu-mor size, depth of muscular infiltration and lymphatic metastasis, but not with the degree of differentiation and intravascular tumor embolus. The logistic regression analysis further confirmed that the lymph node metastasis and tumor diameter are the independent risk factors affecting serum marker levels (SCC-Ag ≥4 ng/ml). Moreover, lymphatic metastasis has more effect on the SCC-Ag. The ROC showed that the best cut off value of SCC-Ag for screening of the lymph node metastasis is 4 ng/ml. Conclusion:Preoperative detection of the serum SCC-Ag is definitely valuable in evaluating the lymphatic me -tastasis in early squamous carcinoma of the cervix, with a critical value of 4 ng/ml.