THE PROGNOSTIC RELEVANCE OF PRETREATMENT SERUM IMMUNOSUPPRESSIVE ACIDIC PROTEIN (IAP) IN PATIENTS WITH SQUAMOUS-CELL CARCINOMA OF THE UTERINE CERVIX - A COMPARISON WITH SQUAMOUS-CELL CARCINOMA ANTIGEN (SCC)

Background - Elevated serum levels of immunosuppressive acidic protein (IAP) have been detected in patients with several malignancies, inclu ding gynecological cancer. The aim of this paper was to compare the pr ognostic relevance of serum IAP and squamous cell carcinoma antigen (S CC) in squamous cell carcinoma of the cervix. Methods - Pretreatment s erum IAP and SCC levels were assessed in 100 patients with squamous ce ll cervical carcinoma divided into two groups according to the treatme nt plan. Group A included 41 patients with FIGO stage Ib-IIa cervical cancer undergoing primary radical hysterectomy and radiotherapy. Group B included 59 patients with FIGO stage Ib-IIIb cervical cancer underg oing neoadjuvant chemotherapy followed by radical hysterectomy or, if unresponsive to chemotherapy, by radiotherapy. Results - Among Group A patients preoperative IAP assay results were related to none of the c ommon prognostic variables, whereas preoperative SCC assay results cor related significantly with tumor size and lymph node status. Lymph nod e status was found to be the only significant prognostic factor for re currence. Among Group B patients, univariate analysis showed that prog ression-free survival (PFS) and survival were significantly related to FIGO stage, tumor size, clinical response to chemotherapy, serum IAP assay, and serum SCC assay using 7 ng/ml as the cut-off. Multivariate analysis showed that clinical response to chemotherapy, FIGO stage, an d serum IAP were independent prognostic variables for PFS, and that cl inical response to chemotherapy and serum LAP were independent prognos tic variables for survival. Conclusions - Pretreatment serum IAP was s ignificantly correlated with the clinical outcome of patients with loc ally advanced squamous cell carcinoma of the cervix undergoing neoadju vant chemotherapy. In these patients pretreatment serum IAP seemed to have a stronger prognostic relevance than serum SCC.