SQUAMOUS-CELL CARCINOMA ANTIGEN - CLINICAL UTILITY IN SQUAMOUS-CELL CARCINOMA OF THE UTERINE CERVIX

This study further defines the clinical utility of squamous cell carci noma antigen (SCC-Ag) in initial squamous carcinoma of the cervix, res ponse to treatment, and in the detection of recurrence. Serum specimen s were drawn and analyzed from patients with squamous cell carcinoma. Charts were reviewed on 272 patients with 1053 samples evaluated. Trea tment of patients prior to the availability of the assay and patients lost to follow-up re suited in lower total numbers of initial and recu rrent values. Data were analyzed to detect trends during and after tre atment. All values at or above the lowest detectable level of antigen were included; that is, 1.5 ng/ml and above. A SCC-Ag value greater th an or equal to 2.0 ng/ml drawn at any time during the disease process has a 96.3% positive predictive value, while a value <2.0 ng/ml is 97. 2% specific for absence of disease. Fifty-three percent of 103 patient s had elevated SCC-Ag levels prior to treatment, with the proportion i ncreasing accordingly with advancing stage at diagnosis. In 70 patient s with recurrence, 81% had elevated values. Squamous cell carcinoma an tigen predicted recurrence an average of 6.9 months prior to detection of clinically evident disease. Patients with initially negative SCC-A g levels may demonstrate elevated values with tumor recurrence. This m arker accurately reflects the response to treatment in patients who ha ve elevated levels prior to treatment. Squamous cell carcinoma antigen is a useful tumor marker in the management of patients with squamous cell carcinoma of the uterine cervix. (C) 1994 Academic Press, Inc.