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目的:探讨血清鳞状细胞癌抗原(squamous cell carcinoma antigen,SCCAg)对宫颈鳞癌诊断及术后疗效的评估价值。方法:采用酶联免疫吸附实验(ELISA)检测血清中SCCAg的水平。研究组:宫颈鳞癌组(IA2-IIA期)50例;对照组1:宫颈上皮内瘤变组(CIN组)25例;对照组2:慢性宫颈炎组25例。研究组在术前、术后分别检测血清SCCAg浓度。对照组仅检测治疗前血清SCCAg浓度。应用ROC曲线等方法分析血清SCCAg水平与宫颈鳞癌临床病理特征、手术疗效的关系。结果:宫颈鳞癌组术前血清SCCAg水平明显高于对照组,差异具有统计学意义(P<0.01)。对照组间差异无统计学意义(P=0.432)。宫颈鳞癌组术后在1年内没有复发的情况下动态检测血清SCCAg水平呈进行性下降,差异具有统计学意义(P<0.001)。宫颈鳞癌组术前血清SCCAg水平与临床分期、肿瘤体积、分化程度、间质浸润、盆腔淋巴结转移等有关(P<0.001)。血清SCCAg诊断宫颈鳞癌及预测盆腔淋巴转移的临界值分别为0.94 ng/ml和3.15 ng/ml,ROC曲线下面积分别为0.904、0.797。结论 :血清SCCAg检测对宫颈鳞癌具有较高的诊断价值,也是评价宫颈鳞癌术后疗效及预测盆腔淋巴结转移的重要指标。
Objective: To investigate the value of serum SCCAg in the diagnosis and postoperative curative effect of cervical squamous cell carcinoma. Methods: Serum levels of SCCAg were measured by enzyme-linked immunosorbent assay (ELISA). Study group: cervical squamous cell carcinoma group (IA2-IIA) 50 cases; control group 1: cervical intraepithelial neoplasia group (CIN group) 25 cases; control group 2: chronic cervicitis group 25 cases. The study group before and after surgery were detected serum SCCAg concentration. The control group only detected serum SCCAg concentration before treatment. The relationship between serum SCCAg levels and clinicopathological characteristics and curative effect of cervical squamous cell carcinoma was analyzed by ROC curve and other methods. Results: The preoperative serum SCCAg level in cervical squamous cell carcinoma group was significantly higher than that in control group, with statistical significance (P <0.01). There was no significant difference between control groups (P = 0.432). Serum SCCAg levels decreased progressively in cervical squamous cell carcinoma patients without recurrent within one year after operation, the difference was statistically significant (P <0.001). Preoperative serum SCCAg level in cervical squamous cell carcinoma was correlated with clinical stage, tumor volume, degree of differentiation, interstitial infiltration, and pelvic lymph node metastasis (P <0.001). Serum SCCAg diagnosis of cervical squamous cell carcinoma and prediction of pelvic lymphatic metastasis of the critical value were 0.94 ng / ml and 3.15 ng / ml, area under the ROC curve were 0.904,0.797. Conclusion: Serum SCCAg detection of cervical squamous cell carcinoma has a high diagnostic value, but also to evaluate the efficacy of cervical squamous cell carcinoma and prediction of pelvic lymph node metastasis is an important indicator.