THE VALUE OF SQUAMOUS-CELL CARCINOMA ANTIGEN AS A PREDICTOR OF NODAL METASTASIS IN CERVICAL-CANCER

Preoperative serum squamous cell carcinoma antigen (SCC) levels were e xamined in 148 cases of stage Ib squamous cervical cancer undergoing r adical hysterectomy. The effect of the pelvic lymph node status on the marker level was examined by comparing 113 cases with cancer limited to the uterus and 23 cases with cancer confined to the uterus and pelv ic lymph nodes using two different multivariate analyses. Ninety-fire percent of patients with cancer limited to the uterus showed SCC level s of 4 ng/ml or below. Nearly two-thirds (65%) of patients with serum levels above 3 ng/ml exhibited pelvic lymph node metastasis. The marke r values exceeding 1 ng/ml increased the risk of nodal metastasis by e ight times, compared with serum levels of 4 ng/ml or below. Multivaria te analyses confirmed that the pelvic lymph node metastasis had a larg er impact on the marker level than did tumor size or depth of stromal infiltration. SCC levels greater than 4 ng/ml can be considered a high -risk zone for nodal metastasis. (C) 1998 Academic Press.