Effect of CT simulation positioning and three-dimensional conformal radiotherapy combined with TP regimen on serum SCC level and prognosis of advanced esophageal cancer / 中国医师杂志

Objective:To investigate the effects of CT simulation positioning and three-dimensional conformal radiotherapy combined with regimen of paclitaxel and cisplatin (TP) on serum squamous cell carcinoma antigen (SCC) level and prognosis in patients with advanced esophageal cancer.Methods:A total of 80 cases of advanced esophageal cancer patients in People′s Hospital of Xinjiang Uygur Autonomous Region from June 2016 to October 2017 were selected and randomly divided into treatment group and control group, with 40 cases in each group. The control group was treated with CT simulation positioning three-dimensional combined cisplatin and Docetaxel, and the treatment group was treated with CT simulation positioning three-dimensional combined TP regimen. The clinical efficacy, tumor marker levels [serum SCC, carcinoembryonic antigen (CEA), carbohydrate antigen-199 (CA-199), human cytokeratin 21-1 fragment (CYFRA21-1)], Karnofsky functional status (KPS) score, Quality of Life(QOL) score, progression free survival period and incidence of adverse reactions were compared between the two groups.Results:After treatment, the total effective rate in the treatment group was 70.00%, which was significantly higher than 55.00% in the control group ( P<0.05); the levels of serum SCC, CEA, CA-199 and CYFRA21-1 in the two groups after treatment were significantly lower than those before treatment ( P<0.05), and those in the treatment group were significantly lower than those in the control group ( P<0.05); after treatment, the QOL and KPS scores in the two groups were significantly higher than those before treatment ( P<0.05), and the scores in the treatment group were significantly higher than those in the control group ( P<0.05); The progression free survival time in the treatment group was significantly longer than that in the control group ( P<0.05); The incidence of adverse reactions in the treatment group was 15.00%, which had no significant difference compared with 25.00% in the control group ( P>0.05). Conclusions:CT simulation positioning three-dimensional combined with TP regimen in the treatment of advanced esophageal cancer has obvious effect, can effectively reduce the level of tumor markers, improve the patient′s physical function and quality of life, improve prognosis , and does not increase the survival rate of adverse reactions, which is safe and effective.

A study for diagnosis of squamous cell carcinoma arising from mature cystic teratoma / 대한산부인과학회지

OBJECTIVE: To evaluate factors for diagnosis of squamous cell carcinoma arising from ovarian mature cystic teratoma and whether squamous cell carcinoma (SCC) antigen, CA125, CA19-9 and CEA is useful for detection of the malignant transformation of mature cystic teratoma of ovary. METHODS: From October 1999 to December 2008, 11 patients with malignant transformation arising from ovarian mature cystic teratoma were treated at Departments of Obstetric and Gynecology in Samsung Medical Center. Demographic characteristics, symptoms, sign, preoperative images, stage, mode of therapy and results of follow up were reviewed retrospectively. RESULTS: The incidence of squamous cell carcinoma arising from ovarian mature cystic teratoma was 0.15% (11/7,345) in this hospital. The median age of patients was 60.8 years (range, 48~73 years). The most common preoperative diagnosis is mature cystic teratoma (n=5), followed by malignant transformation of mature cystic teratoma (n=3), colon cancer (n=2), primary epithelial ovarian cancer (n=1). SCC antigen level was elevated in five patients (45.4%) and CA125 was elevated in seven patients (63.6%). Median longitudinal diameter of ovarian tumors was 11.1 cm. All the patients were surgically staged. CONCLUSION: We should consider women, old aged and had large sized ovarian teratoma, were associated with development of malignant transformation of ovarian mature cystic teratomas, especially squamous cell carcinoma. CEA, CA19-9, and SCC antigen, in addition to CA125, should be used for tumor markers.

Role of Whole Body FDG-PET in the Detection of Recurrent Uterine Cervix Cancer / 대한산부인과학회지

OBJECTIVE: We evaluated the clinical value of whole body FDG-PET to detect recurrent cervix cancer in patients with elevated serum SCC antigen levels but negative conventional imaging techniques such as CT and MRI after primary treatment for uterine cervix cancer. METHODS: Between August 1998 and January 2004, PET scans were performed on 41 patients in whom recurrent cervix cancers were suspected because serum SCC antigen levels were reelevated after primary treatment, but there were no abnormal CT or MRI findings. Recurrence was defined by monitoring serum SCC antigen levels or imaging findings of CT/MR. A value of 1.5 ng/mL was taken as the upper limit of normal of SCC antigen level. RESULTS: Positive PET findings were noted in 27 out of 41 patients, including 10 patients with distant lesions only, 8 patients with local lesions only, one patient with both local and distant lesions, 1 patient with both local lesion and paraaortic lymph node, 4 patients with both paraaortic lymph nodes and distant lesions, and 3 patients with paraaortic lymph nodes only. In detecting recurrent cervix cancer, the sensitivity, specificity, and accuracy of PET were 84.4%, 100%, and 87.8%, respectively. 27 of 41 patients were predicted as recurrence by PET scanning. CONCLUSION: Whole body FDG-PET scan is useful diagnostic tool to locate recurrent cervix cancer in patients with clinically suspected recurrence but negative conventional imaging techniques.

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

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). CONCLUSIONS: Initial pre-treatment levels of serum SCC antigen and Cyfra 21-1 are closely related to FIGO stage, lesion size, lymph node and parametrial involvement in patients with squamous cell carcinoma of the cervix. Also, these markers may be of help to predicting recurrent disease and survival rates.

Correlation between SCC antigen and the prognosis of cervical cancer patients following concurrent chemoradiotherapy / 부인종양

OBJECTIVE: The aim of this study was to determine the correlation between SCC Ag and the prognosis in cervical cancer patients following concurrent chemoradiotherapy (CCRT). METHODS: The charts of 116 patients following concurrent chemoradiotherapy among 330 patients diagnosed to cervical cancer at Yonsei University Medical Center from Jan. 1998 to June 2003 were reviewed retrospectively. Clinical characteristics (age, parity, body mass index), stage, lesion size, cell type, squamous cell subtype, initial SCC Ag (or=1.5), posttreatment SCC Ag (or=1.5) was evaluated with overall survival. Distribution of SCC Ag level before CCRT in relation to FIGO stage and failure pattern in SCC positive patients before CCRT were reviewed. Overall survival was estimated according to respectively, subgroups of initial SCC Ag, SCC Ag after 2nd CCRT and posttreatment SCC Ag. Chi square test and Kaplan Meier test were used for statistical analysis (P<0.05). RESULTS: Overall survival was significantly correlated with only stage (P=0.0014). Two patients (15.4%) among 13 patients with recurrence had SCC Ag<1.5. Subgroups (1.5

The Clinical Significance of Follow Up SCC Levels in Patients with Recurrent Squamous Cell Carcinoma of the Cervix / 대한방사선종양학회지

PURPOSE: To investigate the clinical usefulness of a follow-up examination using serum squamous cell carcinoma antigen (SCC) for the early detection of recurrence in patients treated for cervical squamous cell carcinoma. MATERIALS AND METHODS: 20 patients who were treated for recurrent cervical squamous cell carcinoma between 1997 and 1998, who had experienced a complete remission after radiotherapy and who underwent an SCC test around the time when recurrence was detected, were included in this study. The levels of SCC were measured from the serum of the patients by immunoassay and values less than 2 ng/mL were regarded as normal. The sensitivity of the SCC test for use in the detection of recurrence, the association between the SCC values and the recurrence patterns and the tumor size and stage, and the temporal relation between the SCC increment and recurrence detection were evaluated. RESULTS: The SCC values were above normal in 17 out of 20 patients, so the sensitivity of the SCC test for the detection of recurrence was 85%, and the mean and median of the SCC values were 15.2 and 9.5 ng/mL, respectively. No differences were observed in the SCC values according to the recurrence sites. For 11 patients, the SCC values were measured over a period of 6 months before recurrence was detected, and the mean and median values were 13.6 and 3.6 ng/mL, respectively. The SCC values of 7 patients were higher than the normal range, and the SCC values of the other 4 patients were normal but 3 among them were above 1.5 ng/mL. At the time of diagnosis, the SCC valuess were measured for 16 of the 20 recurrent patients, and the SCC values of the patients with a bulky tumor (> or =4 cm) or who were in stage IIb or III were higher than those of the patients with a non-bulky tumor or who were in stage Ib or IIa. CONCLUSION: The SCC test is thought to be useful for the early detection of recurrence during the follow up period in patients treated for cervical squamous cell carcinoma. When an effective salvage treatment is developed in the future, the benefit of this follow-up SCC test will be increased.

An Analysis of Prognostic Factors in the Uterine Cervical Cancer Patients / 대한방사선종양학회지

PURPOSE: The aim of this study is to analysis of survival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. METHODS AND MATERIALS: From January 1981 to December 1998, eight-hundred twenty-seven uterine cervical cancer patients were treated with radiation therapy. All of the patients were divided into two groups : the radiation therapy only (521 patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and SCC antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were performed with the Kaplan-Meier method and the Cox hazard model, respectively. Median follow-up was 38.6 months. RESULTS: On the radiation therapy only group, 314 patients (60%) achieved complete response (CR), 47 patients (9%) showed local recurrence (LR), 78 patients (15%) developed distant metastasis (DM). On the postoperative radiation therapy group, showed 276 patients (85%) CR, 8 patients (2%) LR, 37 patients (11%) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.0001), treatment modality ( p=0.0010), recurrence ( p=0.0001), Pap smear ( p=0.0329), CEA ( p=0.0001) and SCC antigen ( p= 0.0001). CONCLUSION: This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma.

A Study of Relationship between the Level of Serum SCC Antigen and Recurrence Patterns after Treatment of Uterine Cervix Cancer / 대한방사선종양학회지

PURPOSE: Serum squamous cell (SCC) antigen levels were examined in uterine cervix cancer undergoing radiation therapy, and authors analyzed the relationship between SCC antigen levels and treatment results. MATERIALS AND METHODS: This is a retrospective study of 181 cervical carcinoma patients who received radiotherapy and examined serial serum SCC antigen from 1991 to 1997 at Soonchunhyang University Hospital. One hundred and eighteen patients underwent SCC antigen evaluation at diagnosis The relationship between the serum tumor marker level and disease free survival, recurrence pattern, and other prognostic factors were analyzed according to various statistical methods. RESULTS: The positivity rate (initial serum value above 2.5 ng/ml) was increased with FIGO stage (IB-IIA 57% to IV 91%) and more discriminative than cutoff value of 1.5 ng/ml. Five year disease free survival rates for the stage IB-IIA, IIB, III and IV were 79.2%, 68.7%, 33.4% and 0%, respectively. The 5-year disease free survival rate for patients with serum SCC antigen levels above 5.0 ng/ml was 34% versus 55~62% for patients with normal range (<1.5 ng/ml) or mildly elevated levels (1.5~5.0 ng/ml). Rising SCC antigen levels preceded the clinical detection of disease by a mean of 4.8 months (range 1~13 months). Negative linear corelation was observed between initial SCC antigen levels and relapse free survival (r=-0.226), and by multivariate analysis, initial SCC antigen level had a large impact on the relapse free survival. CONCLUSIONS: SCC antigen assay is a useful aid to predict the prognosis of squamous cell carcinoma of the uterine cervix and to detect recurrence.