Combination detection of serum squamous cell carcinoma antigen and carcino-embryonic antigen for the diagnosis of cervical carcinoma and evaluation of effect / 肿瘤研究与临床

ABSTRACT

Objective To explore the clinical significance of combination detection of serum squamous cell carcinoma antigen (SCC-Ag) and carcino-embryonic antigen (CEA) for the diagnosis,effect evaluation,monitoring and prognosis in cervical carcinoma.Methods Four hundred and twenty-four cases of cervical carcinoma patients diagnosed by pathology and 400 binign gynaecology patients were selected to detect levels of SCC-Ag and CEA by ELISA.Besides,the pelvic color ultrasound results of cervical carcinoma patients were collected and analyzed.Results The positive rates of serum SCC-Ag,CEA and combined detection of cervical carcinoma patients were 55.9 ％(237/424),26.4 ％(112/424),61.8 ％(262/424),which were higher than those of binign gynaecology patients [12.0 ％(48/400),12.5 ％(50/400),14.5 ％(58/400)],and the differences were statistical significance (all P＜ 0.05).The sensitivity of combined detection of SCC-Ag and CEA for diagnosing cervical carcinoma (61.8 ％) was better than that of detection of alone SCC-Ag or CEA (55.9 ％,26.4 ％),and the difference was statistical significance (P ＜ 0.05).The differences of pretreatment serum SCC-Ag and CEA levels in the cervical carcinoma patients who were dependent on clinical stage,pathological type,depth of invasion,lymph node metastasis were statistically significant (all P ＜ 0.05).The combined detection of SCC-Ag and CEA in patients with stage Ⅰ and Ⅱ had higher positive rates [45.5 ％ (71/156),73.2 ％(139/190)] than those of the ultrasound examination [33.3 ％(52/156),51.1％(97/150)] (P＜ 0.05).After surgery or concurrent chemoradiotherapy or surgery combined radiation and chemotherapy,SCCAg levels of patients in post-treatment (median 0.34,0.51,0.33 ng/ml) were much lower than those of pretreatment (median 0.48,3.44,1.29 ng/ml),and CEA levels of post-treatment (median 0.75,0.81,0.71 ng/ml)were also lower than those of pre-treatment (median 1.22,1.53,1.50 ng/ml) (P ＜ 0.05).After treatment,cervical cancer patients with the raised or not decreased to the normal range levels of SCC-Ag and CEA had recurrences or metastasis rates of 33.3 ％(6/18),56.5 ％(13/23) and 46.1％(35/76).Survival rate of the patients with positive SCC-Ag was significantly lower than that of patients with negative (P ＜ 0.05),while the survival rate of patients with positive or negative CEA had no difference (P ＞ 0.05).Conclusions Combined detection of SCC-Ag and CEA can be used as an important indicator to estimate clinical stage,pathological type,depth of invasion,lymph node metastasis,curative effect and prognosis of cervical carcinoma.Combined detection of SCC-Ag and CEA had higher positive rates than pelvic color ultrasound examination for cervical carcinoma patients in stage Ⅰ and Ⅱ.