AI Chat Paper
Note: Please note that the following content is generated by AMiner AI. SciOpen does not take any responsibility related to this content.
{{lang === 'zh_CN' ? '文章概述' : 'Summary'}}
{{lang === 'en_US' ? '中' : 'Eng'}}
Chat more with AI
Powered by AMiner. Clicking this button will take you away from SciOpen.
Home Precision Radiation Oncology Article
Article Link
Cite
EndNote(RIS) BibTeX
Collect
Show Outline
Outline
Show full outline
Hide outline
Outline
Show full outline
Hide outline
Original Article | Open Access

Elevated pretreatment squamous cell Carcinoma Antigen indicates unfavorable treatment outcomes in cervical cancer patients receiving definitive radiotherapy

Dingchao Liu,, Weiping Wang,, Zheng Zeng, Xiaoliang Liu, Yuncan Zhou, Chen Wang, Xiaoyan Li, Ke Hu( )
The Institutional Affiliation: Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Dingchao Liu and Weiping Wang contributed equally to this work. Dingchao Liu and Weiping Wang should be considered the joint first authors.

Show Author Information

Abstract

Objective

To investigate the prognostic value of pretreatment squamous cell carcinoma antigen (SCC Ag) levels for treatment failure prediction in patients with cervical cancer.

Methods

A quantity of 985 patients satisfying the eligibility criteria were included, with a median follow-up duration of 63.7 months. The optimal cutoff value for pretreatment SCC Ag levels was verified by the receiver operating characteristic (ROC) curve. Five-year disease-free survival (DFS), overall survival (OS), and local control (LC) rates were evaluated utilizing the Kaplan-Meier method. Log-rank test and Cox proportional hazards model was implemented to recognize independent prognostic predictors.

Results

The optimal pretreatment SCC Ag cutoff value was 8.85 ng/mL. Patients with pretreatment SCC Ag levels ≥ 8.85 ng/mL presented significantly inferior 5-year DFS (63.8% vs. 81.8%), OS (71.7% vs. 88.7%), and LC (80.5% vs. 91.0%) compared to those with levels < 8.85 ng/mL (all p < 0.001). The results of the multivariate analysis indicated that the pretreatment SCC Ag level was an independent predictor of treatment failure (HR,1.772; 95% CI, 1.366 to 2.299; p < 0.001).

Conclusion

Pretreatment SCC Ag is an effective prognostic factor in patients with cervical cancer undergoing definitive radiotherapy, with a ROC-identified cutoff value of 8.85 ng/mL and elevated SCC Ag indicates unfavorable outcomes.

Keywords

radiotherapycervical cancersquamous cell carcinoma antigen

References

1

Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249.
Crossref Google Scholar
2

Arbyn M, Weiderpass E, Bruni L, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8(2): e191-e203. doi:10.1016/s2214-109x(19)30482-6
Crossref Google Scholar
3

He W-Q, Li C. Recent global burden of cervical cancer incidence and mortality, predictors, and temporal trends. Gynecol Oncol. 2021;163(3):583-592.
Crossref Google Scholar
4

Cohen PA, Jhingran A, Oaknin A, Denny L. Cervical cancer. Lancet. 2019;393(10167):169-182.
Crossref Google Scholar
5

Wang Y, Zhang T, Peng S, et al. Patterns of Treatment Failure after Concurrent Chemoradiotherapy or Adjuvant Radiotherapy in Patients with Locally Advanced Cervical Cancer. Oncol Res Treat. 2021;44(3):76-85.
Crossref Google Scholar
6

Dasari S, Wudayagiri R, Valluru L. Cervical cancer: Biomarkers for diagnosis and treatment. Clin Chim Acta. 2015;445. doi:10.1016/j.cca.2015.03.005
Crossref Google Scholar
7

Kato H, Torigoe T. Radioimmunoassay for tumor antigen of human cervical squamous cell carcinoma. Cancer. 1977;40(4):1621-1628.
Crossref
8

Yoon SM, Shin KH, Kim J-Y, et al. Use of serum squamous cell carcinoma antigen for follow-up monitoring of cervical cancer patients who were treated by concurrent chemoradiotherapy. Radiat Oncol. 2010;5(1):78. doi:10.1186/1748-717x-5-78
Crossref Google Scholar
9

Fu J, Wang W, Wang Y, Liu C, Wang P. The role of squamous cell carcinoma antigen (SCC Ag) in outcome prediction after concurrent chemoradiotherapy and treatment decisions for patients with cervical cancer. Radiat Oncol. 2019;14(1):146.
Crossref Google Scholar
10

Lee SW, Hong JH, Yu M, et al. Serum conversion pattern of SCC-Ag levels between pre- and post-chemoradiotherapy predicts recurrence and metastasis in cervical cancer: a multi-institutional analysis. Clin Exp Metastasis. 2021;38(5):467-474.
Crossref Google Scholar
11

Takeda M, Sakuragi N, Okamoto K, et al. Preoperative serum SCC, CA125, and CA19-9 levels and lymph node status in squamous cell carcinoma of the uterine cervix. Acta Obstet Gynecol Scand. 2002;81(5):451-457.
Crossref Google Scholar
12

Gadducci A, Tana R, Cosio S, Genazzani AR. The serum assay of tumour markers in the prognostic evaluation, treatment monitoring and follow-up of patients with cervical cancer: a review of the literature. Crit Rev Oncol Hematol. 2008;66(1):10-20.
Crossref Google Scholar
13

Chen P, Jiao L, Ren F, Wang DB. Clinical value of serum squamous cell carcinoma antigen levels in predicting chemosensitivity, lymph node metastasis, and prognosis in patients with cervical squamous cell carcinoma. BMC Cancer. 2020;20(1):423.
Crossref Google Scholar
14

Choi KH, Lee SW, Yu M, Jeong S, Lee JW, Lee JH. Significance of elevated SCC-Ag level on tumor recurrence and patient survival in patients with squamous-cell carcinoma of uterine cervix following definitive chemoradiotherapy: a multi-institutional analysis. J Gynecol Oncol. 2019;30(1):e1. doi:10.3802/jgo.2019.30.e1
Crossref Google Scholar
15

Hong JH, Tsai CS, Lai CH, et al. Risk stratification of patients with advanced squamous cell carcinoma of cervix treated by radiotherapy alone. Int J Radiat Oncol Biol Phys. 2005;63(2):492-499.
Crossref Google Scholar
16

Wang W, Zhang F, Hu K, Hou X. Image-guided, intensity-modulated radiation therapy in definitive radiotherapy for 1433 patients with cervical cancer. Article. Gynecol Oncol. 2018;151(3):444-448.
Crossref Google Scholar
17
Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium [published correction appears in Int J Gynaecol Obstet. 2010 Feb;108(2):176]. Int J Gynaecol Obstet. 2009;105(2):103-104.
Crossref
18
Bhatla N, Berek JS, Cuello Fredes M, et al. Revised FIGO staging for carcinoma of the cervix uteri [published correction appears in Int J Gynaecol Obstet. 2019 Nov;147(2):279-280]. Int J Gynaecol Obstet. 2019;145(1):129-135.
Crossref
19

Saleh M, Virarkar M, Javadi S, Elsherif SB, de Castro Faria S, Bhosale P. Cervical Cancer: 2018 Revised International Federation of Gynecology and Obstetrics Staging System and the Role of Imaging. AJR Am J Roentgenol. 2020;214(5):1182-1195.
Crossref Google Scholar
20

Wang W, Liu X, Hou X, et al. Posttreatment squamous cell carcinoma antigen predicts treatment failure in patients with cervical squamous cell carcinoma treated with concurrent chemoradiotherapy. Gynecol Oncol. 2019;155(2):224-228.
Crossref Google Scholar
21

Wang W, Liu X, Meng Q, Zhang F, Hu K. Nomogram for predicting para-aortic lymph node metastases in patients with cervical cancer. Arch Gynecol Obstet. 2018;298(2):381-388.
Crossref Google Scholar
22
Korn EL, Freidlin B. 18 - Clinical Trial Designs in Oncology. In: JE Niederhuber, JO Armitage, MB Kastan, JH Doroshow, JE Tepper, eds. Abeloff's Clinical Oncology. 6th ed. Amsterdam, the Netherlands: Elsevier; 2020:296-307.e2.
Crossref
23

Chen W, Xiu S, Xie X, et al. Prognostic value of tumor measurement parameters and SCC-Ag changes in patients with locally-advanced cervical cancer. Radiat Oncol. 2022;17(1):6.
Crossref Google Scholar
24

Xu D, Wang D, Wang S, Tian Y, Long Z, Ren X. Correlation Between Squamous Cell Carcinoma Antigen Level and the Clinicopathological Features of Early-Stage Cervical Squamous Cell Carcinoma and the Predictive Value of Squamous Cell Carcinoma Antigen Combined With Computed Tomography Scan for Lymph Node Metastasis. Int J Gynecol Cancer. 2017;27(9):1935-1942.
Crossref Google Scholar
25

Zhou Z, Li W, Zhang F, Hu K. The value of squamous cell carcinoma antigen (SCCa) to determine the lymph nodal metastasis in cervical cancer: A meta-analysis and literature review. PLoS ONE. 2017;12(12):e0186165. doi:10.1371/journal.pone.0186165
Crossref Google Scholar
26

Jeong BK, Choi DH, Huh SJ, Park W, Bae DS, Kim BG. The role of squamous cell carcinoma antigen as a prognostic and predictive factor in carcinoma of uterine cervix. Radiat Oncol J. 2011;29(3):191-198.
Crossref Google Scholar
27

Salvatici M, Achilarre MT, Sandri MT, Boveri S, Vanna Z, Landoni F. Squamous cell carcinoma antigen (SCC-Ag) during follow-up of cervical cancer patients: Role in the early diagnosis of recurrence. Gynecol Oncol. 2016;142(1):115-119.
Crossref Google Scholar
28

Zhang L, Zhang H, Huang Y, Xi X, Sun Y. Expression of immune cell markers and tumor markers in patients with cervical cancer. Int J Gynecol Cancer. 2020;30(7):969-974.
Crossref Google Scholar
29

Kong L, Wang J, Cheng J, et al. Comprehensive Identification of the Human Secretome as Potential Indicators in Treatment Outcome of HPV-Positive and -Negative Cervical Cancer Patients. Gynecol Obstet Invest. 2020;85(5):405-415.
Crossref Google Scholar
Precision Radiation Oncology
Volume 7 Issue 3,
September 2023
Pages 173-180
DOI: 10.1002/pro6.1202
Cite this article:
Liu D, Wang W, Zeng Z, et al. Elevated pretreatment squamous cell Carcinoma Antigen indicates unfavorable treatment outcomes in cervical cancer patients receiving definitive radiotherapy. Precision Radiation Oncology, 2023, 7(3): 173-180. https://doi.org/10.1002/pro6.1202

208

Views

0

Crossref

0

Scopus

Altmetrics
Received: 11 April 2023
Revised: 18 May 2023
Accepted: 22 May 2023
Published: 16 July 2023
© 2023 The Authors.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Return