Impact of Radioimmunoscintigraphy on the Management of Colorectal and Ovarian Cancer Patients: A Retrospective Study

Noninvasive differentiation of benign from malignant disease has emerged as an important diagnostic challenge in the current age of health-care cost containment. Most physicians today acknowledge that early and accurate detection of cancer is important in successful treatment. Antibodies have been developed, labeled with radioactive isotopes, and used to detect and treat malignant tumors. During the past few years, several radiolabeled antibodies have received approval from the U.S. Food and Drug Administration for imaging colorectal, lung, ovarian, and prostate carcinomas, thus expanding and improving the physician's ability to detect and follow cancer in patients. At present, there is ample evidence in the literature to suggest that imaging with the ^IIIIn-labeled monoclonal antibody B72.3 is clinically useful for detecting primary/recurrent colorectal and recurrent ovarian carcinomas. In this article, we present a retrospective review of 136 patients from 10 moderate-sized hospitals who underwent a study with radioimmunoscintigraphy (R1S), using the ^IIIIn B72.3 antibody and standard diagnostic examinations for the detection of recurrent colorectal or ovarian carcinoma. The resulting data were analyzed in an effort to determine if (and how) information obtained from this radioimmunoscinti-graphic procedure is being used by referring physicians. Our findings suggest a gradually increasing use of scan findings with the ^IIIIn B72.3 antibody in making patient-management decisions.     

结直肠癌患者血清肿瘤标志物水平与临床病理学特征的关系

目的: 探讨结直肠癌患者手术前血清中肿瘤标志物CEA、CA199、CA242与临床生理病理特征的关系。 方法: ELISA法检测602例结直肠癌患者血清中CEA、CA199、CA242水平。 结果: 1)结直肠癌患者血清中CEA、CA199、CA242水平与性别、年龄、病理类型之间均无密切关系。2)结肠癌患者血清中CEA水平(23.29±7.64)μg/ml、CA199水平(43.11±6.85)U/ml和CA242水平(40.27±6.13)U/ml明显高于直肠癌患者(11.13±1.99)μg/ml、(34.43±3.36)U/ml、(26.06±2.29)U/ml,均P<0.001。3)淋巴结转移的结直肠癌患者CA199水平(47.10±5.04)U/ml和CA242水平(37.70±3.89)U/ml高于无淋巴结转移者(22.38±2.57)U/ml、(18.99±2.15)U/ml均P<0.001。4)远隔脏器转移的结直肠癌患者CEA水平(30.72±3.61)μg/ml、CA199水平(92.22±12.20)U/ml、CA242水平(68.08±7.85)U/ml高于无转移者(9.83±1.62)μg/ml、(26.95±2.27)U/ml、(21.80±1.80)U/ml,均P<0.001。5)Duck’s分期不同,结直肠癌患者CEA、CA199、CA242水平也有差异。随着期别的变化,CEA、CA199、CA242水平也明显升高,P<0.005～<;0.001。6)浸润程度不同,CEA、CA199、CA242水平存在差异,浸全层达浆膜外的患者CEA、CA199、CA24水平明显高于浸全层、浸深肌层和浸浅肌层的患者,P<0.05～<0.005;而三者之间无统计学差异。7)CEA与生长类型无密切相关,只有浸润型的患者,血清中CA199、CA242水平明显高于溃疡型、蕈伞型和缩管型,P<0.05～<0.01。8)肿瘤大小与血清中CEA水平无关;随着肿瘤体积的增大,血清中CA199、CA242水平明显升高。P<0.002～<0.001。9)结直肠癌患者血清中CEA与CA199、CA242之间存在正相关(分别为r=0.189,r=0.194),P<0.01;CA199与CA242之间的相关系数r=0.884,P<0.001。 结论: 1)结直肠患者血清中CEA、CA199、CA242水平与肿瘤的部位和远处转移存在密切相关;2)血清中CA199、CA242水平与结直肠癌患者的各种生理及病理特征存在更加密切关系;3)血清中CEA、CA199、CA242存在正相关,是监测结直肠癌患者病情的最佳组合。     

Dietary Inflammatory Index and Odds of Colorectal Cancer in a Case- Control Study from Iran

Background: In Iran, colorectal cancer (CRC) is the third and fourth leading cause of cancer incidence among menand women, respectively. Diet and inflammation have been suggested as important risk factors for CRC. We examinedthe association between dietary inflammatory index (DII) scores and CRC in a case-control study conducted in Iran.Methods: This study included 71 CRC cases and 142 controls hospitalized for acute non-neoplastic diseases. DIIscores were computed from dietary intake assessed by a previously validated food frequency questionnaire. Logisticregression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI) adjusted for age, sex,education, energy intake, exercise, body mass index (BMI), smoking, family history of cancer, and history of aspirin,acetaminophen, and multivitamin use. Results: Subjects with higher DII scores (i.e., indicating a more pro-inflammatorydiet) had a higher odds of CRC with the DII being used as both a continuous variable (OR continuous = 2.20, 95% CI:1.22-3.87) and as a categorical variable (OR tertile 3 vs tertile1 = 2.47, 95%CI: 1.10-5.55). Conclusion: These resultsindicate that a pro-inflammatory diet is associated with increased odds of CRC in this Iranian population.     

肿瘤标志物的联合检测在胰腺癌诊断中的应用

目的探讨肿瘤标志物联合检测在胰腺癌诊断中的应用价值。方法采用电化学发光法对胰腺癌患者的血清CA19_9、CA242和CEA进行检测。结果3种肿瘤标志物中敏感性和特异性以CA19_9最好,分别为82.0%和79.8%,联合检测三种肿瘤标志物可提高其敏感性,敏感性可达89.0%。结论联合检测肿瘤标志物有助于胰腺癌的早期诊断。     

Clinical Significance of Combined Detection of Serum Tumor Markers in Diagnosis of Patients with Ovarian Cancer

Objective: To explore the predictive value of tumor markers, including cancer antigen 72-4 (CA72-4), cancerantigen 15-3 (CA15-3) and cancer antigen 125 (CA125), in single or combined detection, for the diagnosis ofovarian cancer. Methods: 120 patients diagnosed with ovarian cancer from August 2011 to March 2013 and80 patients diagnosed with benign ovarian tumors were enrolled in this test, along with 50 health examinationwomen randomly selected from the database as controls. Serum levels of CA72-4, CA15-3 and CA125 in this studywere determined by electrochemiluminescence (ECL). Results: Serum levels of CA72-4, CA15-3 and CA125 inovarian cancer were higher than those in healthy group and benign group (P<0.01).The sensitivity of combineddetection of those three tumor markers for diagnosis of ovarian cancer was obviously higher than with singledetection with each marker (P<0.01). Conclusions: CA72-4, CA15-3 and CA125 could be a good combination inthe diagnosis of ovarian cancer. Patients whose tumor markers continue to increase should be highly suspectedof malignancy.     

Level and Evaluation of Tumor Marker CA-125 in Ovarian Cancer Patients in Khyber Pakhtunkhwa,Pakistan

Background: Due to the increase in morbidity and mortality rate, cancer has become an alarming threatto the human population worldwide. Since cancer is a progressive disorder, timely diagnosis is necessary toprevent/stop cancer from progressing to a severe stage. In Khyber Paktunkhwa, Pakistan, many tumors arediagnosed with endoscopy and biopsy; rare studies exist regarding the diagnosis and evaluation of ovariancancer, based on tumor markers like CA-125. Objectives: The objectives of this study were to investigate andevaluate levels of CA-125 in hospitalized ovarian cancer patients. Materials and Methods: In this study, a totalof 63 admitted patients having ovarian cancer by biopsy were included. The level of CA-125 was determinedin the blood of these patients using ELISA technique. Results: Out of 63 patients, the level of CA-125 was highin 52% . The affected individuals were more in the group of 40-60 and the level of CA-125 was comparativelyhigher in patients having moderately differentiated histology than those having well differentiated and poorlydifferentiated tumor histology. Moreover, the highest level of CA-125 was present among the patients havingserous subtype of carcinoma and the common stage of carcinoma was stage II followed by stage III, I and IV.Conclusions: CA-125 level was high in more than 50% of the total patients. Moreover, CA-125 elevation wasmore common in serous subtype and stage II cancer patients.     

No Association between BRCA1 Immunohistochemical Expression and Tumor Grade,Stage or Overall Survival in Platinum-Treated Epithelial Ovarian Cancer Patients

Background: The aim of this work is to assess the frequency of BRCA1 protein immunohistochemical (IHC)expression in epithelial ovarian cancer (EOC) and to evaluate the association of BRCA1 expression with clinicaland pathological characteristics and the overall survival (OS) of patients treated with postoperative platinumbasedchemotherapeutic agents. Materials and Methods: This retrospective study was conducted on 35 cases ofepithelial ovarian cancer selected from the files of the Pathology Department, Faculty of Medicine, MansouraUniversity, Egypt. Immunohistochemistry (IHC) was performed for BRCA1 gene protein. BRCA1 expressionwas compared to patient’s age, tumor histology, grade, stage and OS time. Statistical analysis was carried outwith the SPSS version 16.0 to assess significant associations. Results: BRCA1 nuclear expression was detectedin 40% of EOC, in which a mild increase in the percentage of positive cases was observed with serous histology,stage IV, and grade 3 carcinomas. There was a significant statistical difference in BRCA1 expression with regardto histological subtypes of EOC (p=0.048), but not grade or stage. Mean OS and survival rate were slightly betterfor BRCA1 expressing group, but there was no statistically significant difference (p=0.528). Conclusions: Noassociation between BRCA1 immunohistochemical expression and tumor grade, stage or overall survival wasnoted in platinum-treated epithelial ovarian cancer patients.     

Phase I Study of Afatinib and Selumetinib in Patients with KRAS-Mutated Colorectal,Non-Small Cell Lung,and Pancreatic Cancer

Lessons Learned

• Afatinib and selumetinib can be combined in continuous and intermittent dosing schedules, albeit at lower doses than approved for monotherapy.
• Maximum tolerated dose for continuous and intermittent schedules is afatinib 20 mg once daily and selumetinib 25 mg b.i.d.
• Because the anticancer activity was limited, further development of this combination is not recommended until better biomarkers for response and resistance are defined.

BackgroundAntitumor effects of MEK inhibitors are limited in KRAS‐mutated tumors because of feedback activation of upstream epidermal growth factor receptors, which reactivates the MAPK and the phosphoinositide 3‐kinase–AKT pathway. Therefore, this phase I trial was initiated with the pan‐HER inhibitor afatinib plus the MEK inhibitor selumetinib in patients with KRAS mutant, PIK3CA wild‐type tumors.MethodsAfatinib and selumetinib were administered according to a 3+3 design in continuous and intermittent schedules. The primary objective was safety, and the secondary objective was clinical efficacy.ResultsTwenty‐six patients were enrolled with colorectal cancer (n = 19), non‐small cell lung cancer (NSCLC) (n = 6), and pancreatic cancer (n = 1). Dose‐limiting toxicities occurred in six patients, including grade 3 diarrhea, dehydration, decreased appetite, nausea, vomiting, and mucositis. The recommended phase II dose (RP2D) was 20 mg afatinib once daily (QD) and 25 mg selumetinib b.i.d. (21 days on/7 days off) for continuous afatinib dosing and for intermittent dosing with both drugs 5 days on/2 days off. Efficacy was limited with disease stabilization for 221 days in a patient with NSCLC as best response.ConclusionAfatinib and selumetinib can be combined in continuous and intermittent schedules in patients with KRAS mutant tumors. Although target engagement was observed, the clinical efficacy was limited.     

初诊初治肺癌患者20例呼吸特征标志物研究

[目的]对排除自身影响因素条件下(饮食、药物和吸烟)肺癌患者呼吸标志物进行了研究,探讨呼出气中特征性挥发性化合物对肺癌无创诊断的价值。[方法]本实验通过气相色谱—质谱联用仪对20例初诊初治肺癌患者和11例健康志愿者空腹状态时呼出气体中挥发性化合物进行定性定量分析。[结果]通过曼-惠特尼U检验对肺癌患者以及健康对照组的成分均值比较,筛选出二硫化碳(对照组24.21±19.94ppb,肺癌组1.28±3.95ppb)、正己烷(对照组16.75±16.93ppb,肺癌组0.46±1.18ppb)和乙苯(对照组6.30±2.27ppb,肺癌组1.46±2.12ppb)。3种挥发性化合物浓度差异具有统计意义(P值均<0.05)。二硫化碳、正己烷和乙苯三种物质联合指标的受试者工作特征曲线曲线下的面积为0.932,敏感度为95%,特异性为90.9%,P<0.01。[结论]本研究初步探讨了在排除自身影响因素条件下(饮食、药物和吸烟)的肺癌呼吸特征标志物,为肺癌呼吸标志物研究的进一步发展提供了参考依据。     

Association of Interleukin-10 Genotypes and Oral Cancer Susceptibility in Selected Malaysian Population: A Case- Control Study

Background: Interleukin-10 (IL10) genotypes have been closely correlated to the susceptibility for oral squamous cellcarcinoma. More than half of oral cancers in the world occur in Asia with estimated 168,850 new cases were diagnosedin this geographical region alone. Considering the rising numbers of oral cancer cases in Malaysia, association of IL10A1082G gene polymorphism was correlated. Methodology: 41 oral squamous cell carcinoma (OSCC) cases and 48healthy controls of comparable age, gender, and with habits like smoking, alcohol consumption and betel quid chewingwere selected. In this case-control study, samples were collected from the Oral Cancer Research and CoordinatingCentre (OCRCC), Faculty of Dentistry, University of Malaya, Malaysia. Genotyping conditions were evaluated bypolymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The PCR products were subjectedto digestion by MnlI enzyme (NEB, UK) to screen for the IL10 A-1082G. Digested DNA products were analyzed byelectrophoresis on 4% (w/v) agarose gel, stained with ethidium bromide and imaged under UV illumination. Chi-squaretest and Fisher’s Exact test were used in statistical analysis. Results: AG genotypes were present in 81.3% and 86.0% ofhealthy control and OSCC cases respectively (OR=0.468, 95% CI=0.133-1.653). No significant association was foundbetween IL10 A1082G polymorphism with risk habits, clinico-pathological parameters and 5-years overall survival.The findings also show no significant correlation between the IL10 genotype and features of OSCC within the casegroup as measured by tumor size, lymph node involvement, stage, invasive front, grading, depth, pattern of invasion.Conclusion: This study suggests that functional polymorphism AG of IL10 A1082G may have no influence with OSCCsusceptibility. However, further investigation with larger sample sizes can be conducted to provide additional evidenceto support the lack of association of IL10 A1082G polymorphism in oral cancer.     

血清肿瘤标志物与一线EGFR-TKIs治疗晚期EGFR突变型肺腺癌患者疗效相关性分析

背景与目的 表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinaseinhibitors,EGFR-TKIs)在EGFR突变型肺腺癌人群中能显著提高生存,从而改变了晚期肺癌的治疗模式,但并不是所有EGFR敏感突变者均能从EGFR-TKIs治疗中获益.本研究欲通过外周血肿瘤标志物的检测对突变型肺腺癌患者的靶向治疗进行预测及指导.方法 回顾性分析2009年6月-2014年6月于北京大学肿瘤医院胸部肿瘤内一科一线接受EGFR-TKIs治疗的EGFR突变型Ⅲb期-Ⅳ期肺腺癌患者的临床资料,分析其基线肿瘤标志物与EGFR-TKIs疗效及生存的关系.结果 总体人群客观有效率(objective response rate,ORR) 52.8％,疾病控制率(disease control rate,DCR) 89.3％.基线癌胚抗原(carcino-embryonic antigen,CEA)水平升高者对EGFR-TKIs疗效更佳(ORR 61.3％vs35.9％,DCR 95.2％vs 74.4％,P＜0.001),治疗1个月后CEA、细胞角蛋白19片段(cytokeratin 19 fragments,CYFRA21-1)以及CA125水平下降者有效率更高(ORR分别是61.5％vs 25％,P=0.002;58.5％vs 37.5％,P=0.004;61.8％vs 20％,P=0.027).生存分析中,基线CEA水平正常者较高水平者无进展生存期(progression-free survival,PFS)明显缩短(中位PFS5.9个月vs9.8个月,P=0.027),而基线CYFRA21-1、CA125水平升高者PFS明显缩短(中位PFS 9.0个月vs11.4个月,P=0.029;9.0个月vs 11.5个月,P=0.023).多因素分析显示,美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)评分0-1分、基线CYFRA21-1正常水平、治疗1月后CEA下降阳性患者PFS更长.总生存期(overall survival,OS)与CYFRA21-1、CA125升高有关(中位OS分别为25.1个月vs 52.5个月,P=0.003;22.7个月vs55.0个月,P＜0.001),而多因素分析中总生存与CEA下降有关(P=0.046).结论 治疗前高水平CEA以及治疗后CEA下降可以预测晚期肺腺癌患者一线接受EGFR-TKIs的疗效,而治疗前高水平CYFRA21-1以及CA125则预示着生存期缩短.     

Genetic Characterization of Ovarian Tumor Tissues from Patients with Epithelial Ovarian Cancer in a Philippine Tertiary Hospital: A Descriptive Study

Objective: This study identified genetic variations in ovarian tumor specimens from Filipino epithelial ovarian cancer (EOC) patients using next-generation sequencing. Methods: Genomic DNA was isolated from formalin-fixed paraffin-embedded ovarian specimens from 8 chemosensitive and 8 chemoresistant EOC patients. Targeted next-generation sequencing was done to identify mutations in hotspot regions of common oncogenes and tumor-suppressor genes. The mutations were cross-referenced with dbSNP and ClinVar databases to identify previously reported alterations, and potentially damaging variants were predicted using PolyPhen-2. Results: Our study has identified 85 unique variants, 35 in chemosensitive EOC, 22 in chemoresistant EOC, and 28 in both. Chemosensitive EOC specimens had more exonic single nucleotide variants than chemoresistant EOC specimens. Of the 50 oncogenes and tumor suppressor genes, KDR gene had the most frequent variations in EOC patients. Two of the unique KDR variants identified were novel mutations. Thirty-nine unique protein-modifying genetic variants were identified in all specimens, the majority of which have been previously reported in dbSNP and ClinVar. Conclusion: This study was the first non-BRCA genetic analysis done on ovarian cancer in Filipino patients. Next-generation sequencing was able to identify previously reported alterations with known therapeutic implications which may benefit from targeted therapy instead of standard chemotherapy regimen.     

腹腔镜与开放手术治疗结直肠癌的肿瘤学安全性比较

 目的　评价腹腔镜结直肠癌手术的肿瘤学安全性。方法　选取结直肠癌患者60 例,分为腹腔 镜手术组(LC) 和开放手术组(OC) 各30 例,采用双抗体夹心酶联免疫方法( EL ISA) 检测术前和术后不 同时期血清血管内皮生长因子(VEGF) 、上皮钙粘素( E2Cadherin) 水平,并比较两组间的差异。结果　术 后第7 、10 天OC 组血清VEGF 水平明显高于LC 组,差异有统计学意义( P < 0. 01) ;而血清E2Cadherin 水平LC 组术后缓慢下降,至第10 天达到最低值,OC 组术后亦缓慢下降,至第3 天又缓慢回升,第10 天 基本恢复术前水平,两组术后第10 天血清E2Cadherin 水平比较差异有统计学意义( P < 0. 01) 。结论　 腹腔镜结直肠癌手术与传统开放手术比较,不会增加肿瘤转移的机会。     

结直肠癌血清纤维蛋白原和炎性介质、肿瘤标志物的术前诊断价值

目的探讨纤维蛋白原FIB、炎性介质（CRP、SAA）和肿瘤标志物（CEA、CA19-9、CA72-4）在术前评估结直肠癌分期的价值。方法178例经病理诊断为结直肠癌的患者,均于术前3天测定FIB、CRP、SAA、CEA、CA19-9和CA72-4的水平,并与术后病理分期相比较。结果FIB与CRP、SAA、CEA和CA19-9的相关性有统计学意义,相关系数分别为0.600（ P =0.000）、0.547（ P=0.000）、0.168（ P =0.025）、0.231（ P =0.002）。FIB（ P =0.000）、CRP( P =0.004)、SAA( P =0.046)、CEA( P =0.001)、CA19-9（ P =0.000）和CA724( P =0.040)的值在不同的TNM分期之间差异有统计学意义。 建立诊断转移性结直肠癌的ROC曲线,FIB的ROC曲线下面积A_Z=0.728（ P =0.000）,CRP的A_Z=0.646（ P =0.001）,SAA的A_Z=0.658（ P =0.042）,CA19-9的A_Z=0.665（ P =0.000）,CA72-4的A_Z=0.586（ P =0.049）有统计学意义;当取FIB=3.715g/L为分界点时,FIB诊断转移性结直肠癌的敏感度为65.8%,特异性为66.6%,准确性为66.3%。结论FIB、炎性介质和肿瘤标志物有相关性,运用FIB术前评估有淋巴结转移的结直肠癌患者有潜在应用价值。     

Association of GSTM1, GSTT1, GSTM3, and GSTP1 Genes Polymorphisms with Susceptibility to Osteosarcoma: a Case- Control Study and Meta-Analysis

Background: Some studies have investigated the association of GSTM1, GSTT1, GSTM3, and GSTP1polymorphisms with susceptibility to osteosarcoma; however, these studies results are inconsistent and inconclusive. Inorder to drive a more precise estimation, the present case-control study and meta-analysis was performed to investigateassociation of GSTM1, GSTT1, GSTM3, and GSTP1 polymorphisms with osteosarcoma. Methods: Eligible articleswere identified by a search of several electronic databases for the period up to May 5, 2018. Odds ratios were pooledusing either fixed-effects or random effects models. Results: Finally, a total of 24 case-control studies with 2,405osteosarcoma cases and 3,293 controls were included in the present meta-analysis. Overall, significantly increasedosteosarcoma risk was found when all studies were pooled into the meta-analysis of GSTT1 (Null vs. Present: OR= 1.24795% CI 1.020-1.524, P= 0.031) and GSTP1 polymorphism (B vs. A: OR= 8.899 95% CI 2.722-29.094, P≤0.001). Inthe stratified, significantly increased osteosarcoma risk was observed for GSTT1 polymorphism among Asians (Nullvs. Present: OR= 1.300 95% CI 1.034-1.635, P= 0.025), but not among Caucasians. Conclusions: This meta-analysisdemonstrated that GSTP1 and GSTT1 null genotype are associated with the risk of osteosarcoma. Future large welldesigned epidemiological studies are warranted to validate our results.     

Factors Associated With Local Tumor Control and Complications After Thermal Ablation of Colorectal Cancer Liver Metastases: A 15-year Retrospective Cohort Study

IntroductionThe purpose of this study was to identify risk factors associated with local tumor progression-free survival (LTPFS) and complications after colorectal liver metastases (CLM) thermal ablation (TA).Patients and MethodsThis retrospective analysis included 286 patients with 415 CLM undergoing TA (radiofrequency and microwave ablation) in 378 procedures from January 2003 to July 2017. Prior hepatic artery infusion (HAI), bevacizumab, pre-existing biliary dilatation, ablation modality, minimal ablation margin (MM), prior hepatectomy, CLM number, and size were analyzed as factors influencing complications and LTPFS. Statistical analysis included the Kaplan-Meier method, Cox proportional hazards model, competing risk analysis, univariate/multivariate logistic/exact logistic regressions, and the Fisher exact test. Complications were reported according to modified Society of Interventional Radiology guidelines.ResultsThe median follow-up was 31 months. There was no LTP for MM > 10 mm. Smaller tumor size, increased MM, and prior hepatectomy correlated with longer LTPFS. The major complications occurred following 28 (7%) of 378 procedures. There were no biliary complications in HAI-naive patients, versus 11% in HAI patients (P < .001), of which 7% were major. Biliary complications predictors in HAI patients included biliary dilatation, bevacizumab, and MM > 10 mm. In HAI patients, ablation with 6 to 10 mm and > 10 mm MM resulted in major biliary complication rates of 4% and 21% (P = .0011), with corresponding LTP rates of 24% and 0% (P = .0033). In HAI-naive patients, the LTP rates for 6 to 10 mm and > 10 mm MM were 27% and 0%, respectively.ConclusionsNo LTP was seen for MM > 10 mm. Biliary complications occurred only in HAI patients, especially in those with biliary dilatation, bevacizumab, and MM > 10 mm. In HAI patients, MM of 6 to 10 mm resulted in 76% local tumor control and 4% major biliary complications incidence.     

Application of Tumor Markers SCC-Ag,CEA, and TPA in Patients with Cervical Precancerous Lesions

Background: To determine the potential clinical utility of tumor markers CEA, TPA, and SCC-Ag for earlydetection of cervical precancerous lesions. Materials and Methods: A case-control study was carried out on120 women (46 patients with histologically confirmed cervical precancerous lesions and 74 healthy controls).The significance of serum selected tumor markers in early detection of cervical intraepithelial neoplasia (CIN)were assessed. Results: Of the case group, the rates of CIN I, II, III, was 69.6%, 23.9%, and 6.5%, respectively.According to the manufacturer’s cut-off values of 2ng/ml, 5ng/ml, and 70 U/ml for SCC-Ag, CEA and TPA tests,in that order, SCC-Ag test had a sensitivity of 13%, but CEA and TPA tests could not distinguish between caseand control groups. The diagnostic sensitivities were highest at cut-off values of 0.55 ng/ml for SCC-Ag, 2.6ng/ml for CEA, and 25.5 U/ml for TPA which were 93%, 61%, and 50%, respectively. However, the area under thereceiver operating characteristic curve was the largest for SCC-Ag (0.95 vs. 0.61 and 0.60 for CEA and TPA,respectively). Moreover, there was a highly significant direct correlation between SCC-Ag concentration and thedegree of cervical precancerous lesions (r=0.847, p<0.001). Conclusions: The new cutoff of 0.5 for SCC-Ag testmight be useful as a tumor marker in Iranian patients with CIN and it needs to be more evaluated by studieswith larger populationa.