Can Initial Serum Cyfra 21-1, SCC Antigen, and TPA Levels in Squamous Cell Cervical Cancer Predict Lymph Node Metastases or Prognosis?

Gaarenstroom, Katja N.; Kenter, Gemma G.; Bonfrèr, Johannes M.G.; Korse, Catharina M.; Vijver, Marc J. van de; Fleuren, Gert Jan; Trimbos, J. Baptist

doi:10.1006/gyno.2000.5732

Cited by 78 publications

(80 citation statements)

References 27 publications

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“…A series of different markers has been investigated for their capability in determining the prognosis in cervical cancer. These comprise the most common and established markers such as squamous cell carcinoma antigen, tissue polypeptide antigen, CEA and CA 12-5 (27,28). In accordance with previous research, the present study confirmed the prognostic role of CEA and CA 12-5 in cervical adenocarcinoma (14,27).…”

Section: Discussionsupporting

confidence: 92%

Prognostic Significance of Pre-treatment Serum C-Reactive Protein Level in Patients with Adenocarcinoma of the Uterine Cervix

Bodner‐Adler

Kimberger

Schneidinger

et al. 2016

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Cervical cancer is the third most common cancer in women worldwide, with peak incidence in the 40-to 45-year age group (1). Adenocarcinoma of the uterine cervix is a rare histological subtype, representing up to 20% of cervical carcinoma. International Federation of Gynaecology and Obstetrics (FIGO) stage, histological grade, tumour size, lymphovascular space invasion and lymph node metastasis are major prognostic factors reported in literature (1-3). Nevertheless, additional information guiding the patient's management would be helpful. There is much interest in prognostic factors to permit more accurate patient stratification, that will improve clinical decision-making and may contribute to more rational treatment options. Current guidelines for cervical cancer recommend the same treatment regardless of histological subtype, although lower survival rates were reported for the adenocarcinoma subtype (4). Therefore increasing efforts should focus on prognosticators in adenocarcinoma of the uterine cervix.C-Reactive protein (CRP) is widely used in clinical routine as the most important acute-phase serum protein for monitoring infection. CRP has also been shown to be elevated in patients with a variety of cancer types and an association with prognosis was found. Several studies have shown that patients with cancer have a higher level of circulating CRP than healthy controls prior to clinical diagnosis (5-8). In addition, an increase in serum CRP has been reported to be associated with poor prognosis in oesophageal, liver, colon and lung cancer (9-12). Elevated serum CRP levels have also been linked to impaired survival in patients with different gynaecological malignancies, including cervical, ovarian and endometrial cancer (13-15). However, only few studies reported on the prognostic role of CRP expression in cervical carcinoma (14, 16), with no data investigating exclusively the histological subtype adenocarcinoma of the uterine cervix.The aim of the present study was to evaluate whether the pre-treatment serum CRP level might be used as a prognostic parameter in patients with adenocarcinoma of the uterine cervix and to investigate a possible correlation between the serum CRP level and various clinicopathological parameters. 4691

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Section: Discussionsupporting

confidence: 92%

Prognostic Significance of Pre-treatment Serum C-Reactive Protein Level in Patients with Adenocarcinoma of the Uterine Cervix

Bodner‐Adler

Kimberger

Schneidinger

et al. 2016

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“…In patients with stage IB or IIA squamous cell cervical cancer, sensitivity of an elevated pretreatment concentration of SCC to detect lymph node metastases ranged from 60% to 87%, with specificity ranging from 41% to 91% (385,391,393,395,408,434 ). In a large series of 414 patients with early stage cervical cancer, elevated pretreatment SCC, large tumor size, and lymphovascular space involvement were independent risk factors for the presence of lymph node metastases (393 ).…”

Section: Prediction Of Lymph Node Metastases and Treatment Planningmentioning

confidence: 99%

“…The clinical performance of SCC over a range of decision levels has been found to be poor in identifying lymph node metastases, as reflected by the diagonal appearance of the ROC curve (395 ). The authors concluded that a pretreatment SCC concentration within the reference interval cannot exclude the presence of lymph node metastases and extracervical spread, and hence is of limited use in treatment planning.…”

Section: Prediction Of Lymph Node Metastases and Treatment Planningmentioning

confidence: 99%

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Liver, Bladder, Cervical, and Gastric Cancers

et al. 2010

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Background: Updated National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for the use of tumor markers in the clinic have been developed. Methods: Published reports relevant to use of tumor markers for 4 cancer sites—liver, bladder, cervical, and gastric—were critically reviewed. Results: α-Fetoprotein (AFP) may be used in conjunction with abdominal ultrasound for early detection of hepatocellular carcinoma (HCC) in patients with chronic hepatitis or cirrhosis associated with hepatitis B or C virus infection. AFP concentrations >200 μg/L in cirrhotic patients with typical hypervascular lesions >2 cm in size are consistent with HCC. After a diagnosis of HCC, posttreatment monitoring with AFP is recommended as an adjunct to imaging, especially in the absence of measurable disease. Although several urine markers have been proposed for bladder cancer, none at present can replace routine cystoscopy and cytology in the management of patients with this malignancy. Some may, however, be used as complementary adjuncts to direct more effective use of clinical procedures. Although carcinoembryonic antigen and CA 19-9 have been proposed for use gastric cancer and squamous cell carcinoma antigen for use in cervical cancer, none of these markers can currently be recommended for routine clinical use. Conclusions: Implementation of these recommendations should encourage optimal use of tumor markers for patients with liver, bladder, cervical, or gastric cancers.

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“…In terms of lymph node metastasis, Duk et al demonstrated that elevated pre-treatment SCC antigen levels is an independent factor in squamous cell cancer patients (12), while Gaarenstroom et al proposed that there was no relationship between SCC antigen levels at the time of diagnosis and lymph node metastasis or survival (9). It has also been reported that normal levels of SCC antigen during follow-up cannot exclude persistent or recurrent disease (1,16).…”

Section: Discussionmentioning

confidence: 99%

Relationship between Pre-treatment Serum SCC (squamous cell carcinoma) Antigen, Cyfra 21-1 Levels, and Survival in Squamous Cell Carcinoma of the Uterine Cervix

et al. 2005

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Purpose: To determine the relationship between pretreatment serum squamous cell carcinoma (SCC) antigen and Cyfra 21-1 levels, and survival in patients with invasive squamous cell carcinoma of the cervix.Materials and Methods: One hundred and one cervical squamous cell carcinoma patients were included. Pre-treatment levels of serum SCC antigen and Cyfra 21-1 were measured, with a 5 year minimum follow up. Thirty two recurrent disease (RD) patients were compared to 99 non-recurrent disease (NRD) patients with respect to tumor markers, FIGO stage, lesion size, lymph node status, and parametrial involvement.Results: Pre-treatment serum SCC antigen and Cyfra 21-1 levels were significantly higher in the RD group (p＜ 0.001). Combined serum SCC antigen and Cyfra 21-1 levels showed higher sensitivity for prediction of recurrence (90.6% ). Pre-treatment SCC antigen and Cyfra 21-1 levels showed correlation with high FIGO stage, large lesion size, lymph node status, and parametrial involvement (p＜0.001). Normal pre-treatment levels of SCC antigen and Cyfra 21-1 showed a 5-year survival rate of 93% and 90% respectively, while elevated levels showed significantly decreased survival rate of 63% and 59% , respectively (p＜0.001). Odd ratio for cumulative survival rates were 6.87 for SCC antigen, and 5.07 for Cyfra 21-1 (p＜0.001).Conclusion

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Can Initial Serum Cyfra 21-1, SCC Antigen, and TPA Levels in Squamous Cell Cervical Cancer Predict Lymph Node Metastases or Prognosis?

Cited by 78 publications

References 27 publications

Prognostic Significance of Pre-treatment Serum C-Reactive Protein Level in Patients with Adenocarcinoma of the Uterine Cervix

Prognostic Significance of Pre-treatment Serum C-Reactive Protein Level in Patients with Adenocarcinoma of the Uterine Cervix

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Liver, Bladder, Cervical, and Gastric Cancers

Relationship between Pre-treatment Serum SCC (squamous cell carcinoma) Antigen, Cyfra 21-1 Levels, and Survival in Squamous Cell Carcinoma of the Uterine Cervix

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