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KMID : 0358419920350040533
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Korean Journal of Obstetrics and Gynecology
1992 Volume.35 No. 4 p.533 ~ p.544
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The Efficacy of Tumor Markers SCC Ag, CEA and CA-125 in Patients with Cervical Cancer
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Abstract
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To evaluate the efficacy and diagnostic significance of tumor markers SCC Ag, CEA and CA-125 in patients with cervical cancer, we studied 242 patients with cervical dysplasia and cervical cancer from January 1988 to December 1990.
Three tumor markers were measured coincidently in 160 cases preoperatively.
Serum SCC antigen level of 2.0 ng/ml, CEA level of 5.0 ng/ml and CA-125 level of 35.0 U/ml were determined as cut-off levels.
The results were as follows:
1. In 188 of 242 patients with cervical cancer, the pretreatment positive rate of SCC Ag was 31.4 % (59/188). The mean values and positive rates of SCC Ag by stage were 1.06 ± 0.59 ng/ml (5.9 %) for stage 0, 1.47 ± 1.44 ng/ml´(13.0 %) for stage I, 6.37 ± 17.87 ng/ml (43.4 %) for stage II, 19.33 ± 24.26 ng/ml (80.0 %) for stage III, 2.00 ± 0.83 ng/ml (33.3 %) for stage IV and 12.99 ± 23.16 ng/ml (37.5 %) for recurrent cancer. The mean SCC antigen value and positive rate were significantly increased stepwise by clinical stage from stage 0 to stage III (p < 0.05).
2. In 208 of 242 patients with cervical cancer, the pretreatment positive rate of CEA was 25.0 % (52/208). The positive rates of CEA by staging were 14.8 % for stage 0, 19.4 % for stage I, 28.7 % for stage II, 45.5 % for stage III, and 60 % for stage N. The positive rate was significantly increased stepwise by clinical stage (p < 0.05).
3. In 225 of 242 patients with cervical cancer, the pretreatment positive rate of CA125 was 12.4 % (28/225).
4. In pre-invasive and invasive groups, the mean value and positive rate of SCC Agwere 1.03 ± 0.60 ng/ml (5.5 ~fl 7.41 ±), 17.95 ng/ml (43.4 %), respectively, and it was statistically significant between two groups (P < 0.05). The mean value and positive rate of CEA
were 3.70 ± 2.23 ng/ml (16.9 %), 7.24 ± 12.39 ng/ml, respectively, which was statistically significant (p= 0.001). The mean value and positive rate of CA-125 were 26.71 ± 78.03 U/ml
(7.5 %) and 30.17 ± 75.47 U/ml (14.2 %), respectively, and there was no significant difference between the two groups.
5. Between pre-invasive and invasive groups, the results of pre-operative serum levels
of SCC Ag can be characterized by 43.4 % sensitivity, 94.5 % specificity, 94.9 % predictive value, 41.6 % negative,Positive predictive value and 58.7 % diagnostic efficiency, 30.3 %, 83.1 %, 81.5 %,32.7 % and with 31.8 % and 37.8 % respectively for CA-125e respectively the three and 14.2 %, 92.5 %, 81.5 %, SCC Ag was more valuable than other tumor markers in sensitivity, markers, the result of predictive value, negative predictive value and diagnostic efficiency. The specificity, positive preThese results indicate that measurement of SCC Ag and/or CEA, and/or CA-125 little efficacy in the early detection of cervical cancer considering it´s low rate of have in early cervical cancer. However, in patients with invasive cervical cancer, concomi entmea surements of SCC Ag, CEA and CA-125 may be more useful in determining thera peutic response and early detection of recurrence than measurement of SCC g alone.
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KEYWORD
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