鳞癌抗原在子宫颈鳞癌中的应用价值

目的:探讨鳞癌抗原(SCCAg)在子宫颈鳞癌中的临床应用价值.方法:微粒子酶免法检测124例子宫颈鳞癌患者治疗前血清SCCAg值,对照组180例为妇科良性疾病患者.早期患者(Ⅰ～Ⅱa期)术后一周重复检测SCCAg值,部分根治手术患者随诊中监测.结果:SCCAg在子宫颈鳞癌中的敏感性为73.4%,特异性为96.1%.SCCAg阳性率随临床分期进展而增高,差异有显著性(P＜0.005),早期患者(Ⅰ期和Ⅱa期)术前 SCCAg值异常者术后均下降至正常水平,差异均有显著性(P＜0.001).部分术后患者在3年随访期内血清SCCAg值在正常水平.结论:SCCAg是子宫颈鳞癌较特异的肿瘤标志物,可以作为子宫颈癌辅助诊断指标,评估子宫颈癌手术疗效,在早期浸润癌中的临床意义值得进一步研究.     

Bleomycin in verrucous squamous cell carcinoma of the oesophagus.

A case of verrucous squamous cell carcinoma of the oesophagus treated with bleomycin is reported. Bleomycin brought prompt reduction of the tumour and relief of symptoms. There have been no previous reports on experience with anti-cancer agents for verrucous carcinoma of the oesophagus. Administration of bleomycin might be an effective treatment for verrucous carcinoma of the oesophagus.     

Huge clear cell squamous cell carcinoma of the head

To the editor:An 85-year-old woman,presented with a macula in the front region of parietal bone one year ago,which was slightly protruding from the epidermis without pain and pruritus.After scratching,ulceration and the scope was increasing gradually.A month ago,the tumor was about walnut size,and now about egg size,accompanied with bleeding when knocked,without special feeling.Apart from this,the patient has been suffering from hypertension,diabetes for many years.The size of the tumor was 6 cm × 7 cm × 8 cm,dark red,hard shell,endoplasmic soft.The surface was contaminated,oozy,scabing,poor activity,the boundary was not clear,and pressing with no feeling.The pathological examination showed squamous cell carcinoma (SCC),as shown in Figure 1.Immunohistostaining revealed positive staining for PAS and ABPAS in the tumor tissue.We also performed immunohistostaining analysis,such as keratins AE1/AE3,EMA,cytokeratin 7,cytokeratin 18,cytokeratin 20,vimentin,S-100,HMB45,CD68,CKH and CD34.Of which,keratins AE 1/AE3,cytokeratin 18,CKH,CD34 and EMA were positive,others were negative.The tumor was diagnosed as huge clear cell SCC.After expansion excision,skin grafting,abdominal skin surgery,postoperative recovery was uneventful,and flakiness has survived well.     

Metastatic ovarian squamous cell carcinoma

Ovarian squamous cell carcinoma is usually associated with germ cell tumours (dermoid cyst) or endometriosis in primary cancer. While tumour metastasis to the ovary is common and often bilateral in over 50 percent of cases, metastatic cervical squamous cell carcinoma to the ovary is infrequent compared to adenocarcinoma from other extraovarian primaries and the cervix. We report two cases of unilateral metastatic ovarian squamous cell carcinoma from the uterine cervix in two women aged 38 years and 48 years, respectively. They presented with abdominopelvic masses, clinically thought to be tuberculosis and primary ovarian tumour, respectively. Both had laparotomy which revealed multinodular ovarian masses with extensive extra-ovarian involvement of the corpus and uterine cervix by tumour and omental seedlings. Tissue microscopy showed total replacement of ovarian stroma by tumour with necrotic foci and containing infiltrating nests and cords of malignant squamous cells with prominent intercellular bridges. No evidence of teratoma or endometriosis was seen in the histology sections. They were both diagnosed with metastatic ovarian squamous cell carcinoma with advanced stage disease primary in the uterine cervix. Ovarian metastatic squamous cell carcinoma from the uterine cervix may occur with advanced stage cervical carcinoma. Unilateral multinodular ovarian mass with extensive extra-ovarian tumour involvement should raise suspicion of metastasis rather than of primary tumour. Early and prompt diagnosis is desirable in the management of these patients.     

鳞状细胞癌抗原在复发性宫颈鳞癌患者中的应用

目的:研究血清鳞状细胞癌抗原(SCCAg)在复发性宫颈鳞癌患者临床诊治及监测中的意义.方法:分析2006年11月至2009年1月32例宫颈鳞癌复发患者的全部病历及随访资料,分析患者复发时,复发后治疗中、治疗后的SCCAg水平与患者2年生存率的关系.结果:宫颈癌患者复发时血清SCCAg水平、血清SCCAg是否提前升高及复...     

Management of tonsillar squamous cell carcinoma

Objective To discuss treatment options for tonsillar squamous cell carcinoma.Methods A total of 108 patients with biopsy-proven tonsillar squamous cell carcinoma, treated between 1984 and 2000, were reviewed, including 82 men and 26 women, with ages ranging from 19 to 70 years. Treatments consisted of either radiotherapy and surgery reserved as salvage treatment( Salvage Surgery, 83 patients), or planned surgery with preoperative radiation ( Planned Surgery, 25 patients). Radiotherapy was delivered primarily in a dosage of 60 -70 Gy for Salvage Surgery patients and 40 -50 Gy for Planned Surgery patients. Both salvage and planned surgeries were radical, with resection of the lateral oropharyngeal wall, segmental resection of the mandible and neck dissection.The pectoralis major myocutaneous flaps were used to repair surgical defects.Results The percentages of radical surgery used in the Salvage Surgery and Planned Surgery groups were 24. 1% (20/83) and 88.0% (22/25), respectively ( P=0. 000). The local recurrence rates were 28.9% (24/83) and 20.0% (5/25) in the Salvage Surgery and Planned Surgery groups,respectively (P= 0. 378). The neck recurrence rates were 9.6% (8/83) and 8. 0% (2/25) in the Salvage Surgery and Planned Surgery groups respeatively (P = 0. 804 ). The 5-year survival rates were 59.3% and 55. 3% in the Salvage Surgery and Planned Surgery groups, respeatively ( P = 0. 7056).Conclusions Although the two treatments had a similar survival rate, Salvage Surgery avoided 60% commando operations compared with the Planned Surgery group, which benefits to recovery of oral functions. Primary radiotherapy is recommended as the treatment of choice for tonsillar squamous cell carcinoma After radical radiotherapy, salvage surgery should be undertaken in the case of tumor remnants or recurrences.     

Hypercalcemia in squamous cell carcinoma of the skin

Squamous cell carcinoma of the skin is an extremely rare cause of hypercalcemia associated with malignant neoplasms. The case of a patient with extensive squamous cell carcinoma of both buttocks and thighs, with severe hypercalcemia is reported. The data presented indicate secretion of a humoral factor by the tumor, producing hypercalcemia.     

Primary squamous cell carcinoma of the fallopian tube

To the editor： Primary squamous cell carcinoma of the fallopian tube （PSCCFT） is one of the rarest gynecological malignancies with only ten reported cases in the English language literature. We present the eleventh case and briefly review it.     

血清鳞癌抗原SCC-Ag测定在诊断宫颈癌复发中的意义

目的:评价血清鳞状细胞癌抗原(SCC-Ag)的测定在诊断宫颈癌复发中的作用。方法:回顾分析安徽省立医院2006年6月～2012年3月经影像学或病理证实的86例宫颈鳞癌治疗后达到完全缓解(CR)的患者,采用雅培公司提供的全自动免疫分析系统(Axsym)检测血清SCC-Ag数值,比较分析该抗原改变的临床意义。结果:86例宫颈鳞癌患者中29例发生复发,复发患者SCC-Ag检测值均数明显高于未复发患者;SCC-Ag最佳临界值为1.6μg/L,灵敏度为93.1%,特异度为91.2%。宫颈癌复发诊断中SCC-Ag检测结合正电子发射计算机断层显像/计算机体层扫描(PET-CT)检查早期检出率可能优于其他影像学检查。结论:血清鳞状细胞抗原是宫颈鳞癌较特异的肿瘤标志物,可做为判断宫颈鳞癌复发的辅助诊断指标,其结合PET-CT可能有助于提高复发性宫颈鳞癌的早期诊断率。     

鳞状细胞癌抗原检测在预测早期宫颈鳞癌淋巴结转移中的意义

目的：探讨鳞状上皮细胞癌抗原（SCCAg）检测在预测早期宫颈鳞癌淋巴结转移中的作用。方法：对78例Ⅰ期和Ⅱa期早期宫颈鳞癌患者行手术治疗,确定淋巴结转移情况。手术当天晨取血样,快速荧光酶标法测定SCCAg。结果：早期宫颈鳞癌有淋巴结转移者SCCAg测定值高于未发生淋巴结转移者（t=7.890,P=0.000）。多因素分析调整后SCCAg水平与宫颈鳞癌淋巴结转移的OR值为1.669（Wald=9.124,P=0.000）,95%CI为1.112～2.226。SCCAg对早期宫颈鳞癌淋巴结转移预测的ROC的AUC为0.713（P=0.001）,95%CI为0.606～0.820。当截断值为3.5ng/ml时,特异度为0.714、灵敏度为0.651、Youden指数为0.365,其预测价值最佳。结论：SCCAg对早期宫颈鳞癌淋巴结转移有较好的预测价值,当截断值为3.5ng/ml时,预测价值最佳。