Clinical value of serum squamous cell carcinoma antigen levels in predicting chemosensitivity, lymph node metastasis, and prognosis in patients with cervical squamous cell carcinoma

Peng Chen, Liang Jiao, Fang Ren, Dan-Bo Wang, Peng Chen, Liang Jiao, Fang Ren, Dan-Bo Wang

Abstract

Background: Our aim was to investigate the value of serum squamous cell carcinoma (SCC) antigen levels in predicting chemosensitivity, lymph node metastasis, as well as prognosis in patients with cervical squamous cell carcinoma who received neoadjuvant chemotherapy (NACT).

Methods: This retrospective study enrolled 103 patients with cervical squamous cell carcinoma and then compared the SCC antigen levels between patients who underwent NACT followed by radical surgery (NACT group) and those who underwent radical surgery alone (conventional group), and a correlation analysis between SCC antigen levels and chemosensitivity, lymph node metastasis, or survival time was conducted.

Results: The SCC antigen levels changed after NACT and were associated with chemosensitivity. Moreover, the optimal cut-off value of the percentage decrease in SCC antigen level after the first chemotherapy (FSCC (%)) was 42.0%, which could be used for assessment of chemosensitivity. The rate of positive lymph nodes in patients with pretreatment SCC antigen levels ≥3.9 ng/mL was significantly decreased after NACT. The overall survival (OS) of NACT group was significantly longer than that of conventional group when the pretreatment SCC antigen levels were ≥ 4.55 ng/mL. The OS and progression-free survival rates of patients with SCC antigen levels < 2.7 ng/mL were longer than those ≥2.7 ng/mL after the first chemotherapy.

Conclusions: The 42.0% of FSCC (%) after NACT is a reliable indicator of chemosensitivity. Pretreatment and posttreatment SCC antigen levels can be used in evaluating the lymph node metastases and prognosis of patients with cervical squamous cell carcinoma.

Keywords: Cervical squamous cell carcinoma; Chemosensitivity; Lymph node metastasis; Neoadjuvant chemotherapy; Prognosis; Serum squamous cell carcinoma antigen.

Conflict of interest statement

All authors declare no conflict of interests.

Figures

Fig. 1
Fig. 1
Comparison of serum squamous cell carcinoma (SCC) antigen levels between different treatments. a The SCC antigen levels of patients in the NACT and conventional groups; b The SCC antigen levels of patients in the NACT group before chemotherapy, after the first chemotherapy and before surgery; c and d The SCC antigen levels of patients in the chemotherapy-sensitive and chemotherapy-insensitive groups before and after the first chemotherapy
Fig. 2
Fig. 2
Receiver operator characteristic (ROC) curve analysis showed the value of the percentage decrease in of SCC antigen levels in predicting the chemosensitivity of patients in the NACT group. FSCC (%): Percentage decrease in SCC antigen level after the first chemotherapy; TSCC (%): Percentage decrease in of SCC antigen level after total chemotherapy

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