摘要目的 探讨鳞状细胞癌抗原(SCC-Ag)在宫颈鳞状细胞癌辅助诊断、治疗及预后监测中的临床意义.方法 收集2008年8月至2010年10月于中国医科大学附属盛京医院妇科病房治疗的宫颈鳞癌病例1195例、非鳞癌类型宫颈癌54例,宫颈上皮内瘤变病例325例及健康妇女病例69例的血清SCC-Ag浓度,回顾性分析其与宫颈鳞状细胞癌临床病理特征的相关性,及其在诊断、治疗和随访监测中的水平变化.结果 血清SCC-Ag对于宫颈鳞状细胞癌诊断的敏感度和特异度分别为62.32％和90.10％,其对宫颈癌诊断的最佳临界值为1.45 μg/L.治疗前血清SCC-Ag水平在宫颈鳞状细胞癌的临床分期、组织分化程度、浸润深度、淋巴结转移间差异均有统计学意义(均P ＜0.01).106例进行根治性手术及264例接受放化疗的宫颈鳞癌患者治疗后血清SCC-Ag水平明显下降,与治疗前比较差异均有统计学意义(均P＜0.05).血清SCC-Ag浓度与人乳头瘤病毒(HPV)机会性感染存在关联(均P ＞0.05).治疗前血清SCC-Ag浓度用于估计早期宫颈鳞癌淋巴结转移和宫颈鳞癌预后风险的最佳临界值分别为2.15和12.1 μg/L.结论 SCC-Ag是宫颈鳞癌较特异的肿瘤标志物,与宫颈鳞癌的各项临床病理特征相关,对宫颈鳞癌的辅助诊断、治疗效果评价以及预后监测具有重要的临床参考价值.

abstractsObjective To explore the clinical significance of squamous cell carcinoma antigen (SCC-Ag) in the diagnosis,treatment and prognosis of cervical squamous cell carcinoma Methods The serum SCC-Ag concentrations were measured for 1195 patients with cervical squamous cell carcinoma,54patients with non-squamous cell type cervical cancer,325 patients with cervical intraepithelial neoplasm and 69 healthy women treated at Gynecology Ward of Shengjing Hospital,China Medical University from August 2008 to October 2010.And the correlations with their clinical pathological features of squamous cell carcinoma were analyzed and the changes in the diagnosis,treatment and prognosis monitored. Results Serum SCC-Ag in patients with cervical squamous cell carcinoma showed a sensitivity of 62.32％ and a specificity of 90.10％ with the optimal cutoff point of diagnosis at 1.45 μg/L.The differences of pretreatment serum SCC-Ag levels were statistically significant in clinical stage,histological differentiation,depth of invasion and lymph node metastasis ( P ＜ 0.01 ).The posttreatment serum SCC-Ag levels of 106 patients undergoing radical surgery and 264 patients on chemotherapy significantly decreased and were significant different with their pretreatment levels ( P ＜ 0.05 ).There was no relationship of serum SCC-Ag levels and human papillomavirus (HPV) opportunistic infection (all P ＞ 0.05 ).The best threshold values of pretreatment serum SCC-Ag concentration for predicting early postoperative cervical lymph node metastasis and prognosis of cervical cancer were 2.15 and 12.1 μg/L respectively.Conclusion As a relatively specific tumor maker for cervical squamous cell carcinoma,squamous cell carcinoma antigen is correlated with clinicopathological features of cervical squamous cell carcinoma.And it has important clinical reference values in the diagnosis,prognosis,follow-up evaluation and treatment monitoring of cervical squamous cell carcinoma.