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KMID : 0358419940370040731
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Korean Journal of Obstetrics and Gynecology
1994 Volume.37 No. 4 p.731 ~ p.742
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The Effecacy of Tumor Markers SCCA, CEA and CA-125 in Patients with Squamous Cell Carcinoma of the Uterine Cervix
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김경률
김정현/한상원/이영진/한혁동/차동수
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Abstract
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To evaluate the efficacy and diagnostic significance of tumor markers SCCA, CEA and CA-125 in patient with invasive cervical cancer, we studied 197 patients with cervical carcinoma in situ and cervical cancer from March 1992 to July 1993.
There tumor markers were measured coincidently in 140 cases preoperatively.
Serum SCCA level of 2.5ng/ml. CEA level of 4.0ng/ml and CA-125 level of 35.0U/ml were determined as cut-off levels.
@ES The results were as follows:
@EN 1. The average serum concentration of CEA of control group was 1.29±1.15ng/ml and that of study group was 6.59±12.64ng/ml(P<0.01).
2. In 181 of 197 patients with cervical cancer, the pretreatment positive rate of SCCA was 36.5%(66/181). The mean values and positive rates of SCCA by stage were 1.49±3.51 ng/ml(7.7%) for stage 0, 3.44±9.14ng/ml(20.7%) for stage I,
7.14±11.12ng/ml
(56.1%) for stage II;24.48±39.13ng/ml(100%)for stage III, 11.43±2.36ng/ml(100%)for stage IV. 35.04±61.01ng/ml(50%) for recurrent cancer. The mean SCCA value and positive rate were significantly increased stepwise by clinical stage from stage I
to
stage III (P<0.05).
3. In 170 of 197 patients with cervical cancer, the pretreatment positive rate of CEA was 27.1%(46/170).
4. In 160 of 197 patients with cervical cancer, the pretreatment positive rate of CA-125 was 19.4%(31/160).
5. In pre-invasive and invasive group, the mean value and positive rate of SCCA were 1.49±3.51ng/ml(7.7%), 8.24±20.44(44.4%0, respectively, and it was statistically significant between two groups(P<0.05). The positive rate of CEA was 114%,
31.1%,
respectively, which was statistically significant (P<0.05). The positive rate of CA-125 was 0.1%, 23.4%, respectively, which was statistically significant(P<0.05).
6. Between pre-invasive and invasive group, the result of pre-operative serum levels of SCCA can be characterized by 36.5% sensitivity, 96.4% specificity, 98.5 positive predictive value, 81.0% negative predictive value, 44.5% diagnostic
efficiency,
with 27.1%, 97.7%, 97.9%, 74.3%, 41.6% respectively for CEA, and 19.4%, 82.6%, 79.5%, 77.2%, 33.5% respectively for CA-125. Among the three tumor markers, the result of SCCA was more valuable than other tumor markers in sensitivity, positive
predictive
value, negative predictive value and diagnostic efficiency.
These results indicate that measurement of SCCA and/or CEA, and/or CA-125, have little efficacy in the early detection of cervical cancer considering it's low rate of positivity in early cervical cancer. However, in patients with invasive
cervical
cancer, concomitent measurement of SCCA, CEA and CA-125 may be more useful in determining prognosis, therapeutic response and early detection of recurrence than measurement of SCCA alone.
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KEYWORD
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