Predicative value of serum squamous cell carcinoma antigen level in prognosis of patients with cervical cancer receiving chemoradiotherapy
Objective To explore the effect of serum squamous cell carcinoma antigen(SCC-Ag)on recurrence of cervical cancer patients receiving concurrent chemoradiotherapy.Methods Clinicopathological data and SCC-Ag levels of 205 squamous cervical cancer patients receiving chemoradiation therapy in Nanjing Drum Tower Hospital from September 2015 to December 2022 were analyzed retrospectively.Receiver operator characteristic(ROC)curve was used to analyze the effects of pre-and post-treatment SCC-Ag level on prognosis of cervical cancer patients receiving concurrent chemoradiotherapy,and the difference of disease free survival(DFS)between high level SCC-Ag and low level SCC-Ag were explored.The influencing factors of recurrence in patients with cervical squamous cell carcinoma after radiotherapy and chemotherapy were analyzed using Logistic regression analysis.Results Among the 205 patients,23 relapsed and 182 did not relapse.The levels of SCC-Ag in the non-recurrent group and the recurrent group before treatment were 5.99(2.43,16.07)ng/ml and 21.97(5.81,39.94)ng/ml,respectively.The levels of SCC-Ag in the non-recurrent group and recurrent group after treatment were 1.45(1.10,1.89)ng/ml and 1.80 ng/ml(1.19,2.43)ng/ml,respectively.The levels of SCC-Ag in non-recurrent patients before and after treatment were lower than those in recurrent patients,and the differences were statistically significant(P＜0.05).ROC curve showed that the cut-off value of pre-treatment SCC-Ag level was 19.06 ng/ml for predicting recurrence with sensitivity of 0.61,specificity of 0.80 and the area under the curve(ACU)of 0.672.The cut-off value of post-treatment SCC-Ag level was 1.70 ng/ml for predicting recurrence with sensitivity of 0.65,specificity of 0.78 and ACU of 0.641.Pre-and post-treatment SCC-Ag levels were divided into high and low SCC-Ag groups by their own cut-off value,and 5-year disease free survival rates were shorter with statistical significant in high SCC-Ag group compared with low SCC-Ag group(P＜0.05).Multivariate Logistic regression analysis showed that tumor stage(OR=3.772,95％CI:1.271-11.198,P=0.017)and post-treatment SCC-Ag level(OR=1.341,95％CI:1.062-1.694,P=0.014)were independent predictors of recurrence in patients with cervical cancer undergoing radical chemoradiotherapy.Conclusion In cervical squamous cell carcinoma patients,high levels of SCC-Ag in both before and after treatment indicate poor prognosis.Among chilinicopathological features,tumor stage and post-treatment SCC-Ag are independent predictors for recurrence in patients with cervical cancer.
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