Publication details
Prognostický význam tumor markeru SCCA u pacientek s operabilními stadii dlaždicobuněčného karcinomu děložního hrdla
| Title in English | The prognostic value of the SCCA tumour marker in patients surgically treated for squamous cell cervical cancer |
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| Authors | |
| Year of publication | 2011 |
| Type | Article in Periodical |
| Magazine / Source | Praktická gynekologie |
| MU Faculty or unit | |
| Citation | |
| Field | Gynaecology and obstetrics |
| Keywords | cervical cancer; SCCA (Squamous Cell Carcinoma Antigen); metastasis; lymph node; radical hysterectomy ; pelvic lymphadenectomy |
| Description | Evaluation of the role of the SCCA (Squamous Cell Carcinoma Antigen) tumour marker in the prognosis of patients with surgically treated squamous cell cervical cancer, focusing on malignant lymphadenopathy and recurrence of the disease. Material and methods: We retrospectively analyzed 110 patients who had undergone radical surgical treatment of early stage squamous cell cervical cancer between 2000–2008 in the Department of Gynaecology and Obstetrics, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno. An association between SCCA serum levels and local tumour size (T), determined by the definitive postoperative histology, were explored, as were any associations between regional malignant lymphadenopathy (N) and serum levels of this tumour marker. Based on their postoperative TNM classification and risk factors, the patients were referred either for follow-up or for adjuvant therapy in the form of radiotherapy or combined chemoradiotherapy, respectively. SCCA serum levels obtained during the regular one-year follow-up or at the manifestation of clinical complaints were also evaluated to detect recurrence of the disease. Conclusion: SCCA cannot be used for the diagnosis of squamous cell cervical cancer as its elevation occurs only with an increasing volume of the tumour. SCCA negativity does not exclude metastatic involvement of regional lymph nodes; the marker specificity in our sample was 92%. SCCA elevation above the upper limit of normal is associated with an increased risk of malignant lymphadenopathy, sensitivity of this marker for metastatic regional lymph nodes involvement increases significantly only at the two- and multiple-fold SCCA elevation above the upper limit of normal (almost 70% in our group). Consequently, it is necessary to determine the status of regional lymph nodes as soon as the initial stage of cervical cancer (microinvasive stage T1a1 with lymphovascular invasion); significant risk of regional lymphadenopathy is then clearly associated with high-volume tumours. SCCA is a sensitive marker for recurrence in patients with this tumour marker elevation before the primary operation. Most recurrences are manifested within the first two years after the primary therapy, serum positivity is found in approximately 80% of recurrences in larger files. |