Results of cervical cancer patients treated according to clinical practice guideline in Siriraj Hospital.

Patients with cervical cancer stage Ib-IVa treated with curative intent at Siriraj Hospital between January and December 2002 were included in the study. There were 362 patients with an age range of 26-86 years old. We found that 65.3% of the patients were treaded according to Siriraj Hospital’s clinical practice guideline (CPG) and 34.7% were not treated according to the CPG. Early results of the treatment showed that 70.4% of the patients treated according to the CPG had complete response at 3 months. After further follow up and salvage treatments, five more patients treated according to CPG accomplished complete responses. The overall results of CPG treatment were comparable to the result of cervical cancer treatment in the literature.

Evaluation of clinical significance of a new tumour marker, cyfra21-1, in diagnosios of squamous cell cervical cancer: A preliminary study.

The purpose of this study was to evaluate the significance of Cyfra21-1 as a new tumour marker in the diagnosis of squamous cell cervical cancer. Cyfra21-1 enzyme immunoassay was used for the determination of Cyfra21-1 levels in sera of 120 cervical cancer patients and 17 normal control cases. According to the International Federation of Gynaecology and Obstetrics (FIGO) stage, these cervical cancer patients were staged at CIN or CIS, stage I, stage II and stage III (19,17,42 and 42 cases, respec-tively). The 17 normal controls comprised five healthy women and 12 patients with benign gynaecological diseases and tumours that had presented negative results from Papanicolauo smears. We found that the normal value of serum Cyfra21-1 level was 0.99 + 0.28 ng/ml (mean+ 2SE). Serum Cyfra21-1 levels of the cervical cancer patients increased depending on the severity of the disease. Moreover, the Serum Cyfra12-1 levels of only the patients with FIGO stage III were significantly higher than those of the normal controls, and the patients in CIN or CIS and stage I (p=0.0055). The serum Cyfra21-1 levels of the normal controls the patients in CIN or CIS, stage I, and stage II differed insignificantly from one another. This test showed a sensitivity of 65 per cent and specificity of 82 per cent. The ROC curve was used to determine the cut-off value (1.3 ng/ml) of the increased levels. A prospective study should be further performed to evaluate the usefulness of this marker as a non-invasive modality for diagnosis and monitoring cervical cancer in the future.