Can initial serum Cyfra 21-1, SCC antigen, and TPA levels in squamous cellcervical cancer predict lymph node metastases or prognosis?

Objective. The aim of this study was to determine whether lymph node metast ases or prognosis can be predicted by initial serum Cyfra 21-1, tissue poly peptide antigen (TPA), and squamous cell carcinoma antigen (SCC-Ag) levels in squamous cell cervical cancer. Methods. Pretreatment serum levels of 92 patients were correlated with clin icopathologic parameters and prognostic data. The clinical performance of t he tests was evaluated by their receiver operating characteristic curves. T he prognostic power of the variables was assessed using Cox regression anal ysis. Results. Serum levels of each marker were significantly related to tumor st age, size, and depth of infiltration. The clinical performance of each mark er in predicting lymph node metastases or parametrial involvement was poor. In the stepwise Cox regression analysis, regarding patients with early sta ge cervical cancer (stage Ib/IIa, n = 63), tumor size (P = 0.0005) was the only independent prognostic factor for disease-free interval, Lymph node st atus (P = 0.0014), tumor size (P = 0.004), and parametrial involvement (P = 0.025) were independent risk factors for survival. Considering all patient s with stages la through IVb disease, tumor size (P = 0.0001) and TPA level (P = 0.026) were independent risk factors for disease-free interval, where as tumor size (P = 0.0001) and parametrial involvement (P = 0.0002) were ri sk factors for survival. Conclusions. Pretreatment Cyfra 21-1, TPA, and SCC-Ag levels were strongly related to tumor burden, but insufficiently reliable for identifying patien ts at risk of the presence of lymph node metastases or parametrial involvem ent. Serum levels of each marker showed no independent prognostic value in early stage cervical cancer. (C) 2000 Academic Press.