Combined Detection Of SCC-Ag And CYFRA21-1 To Predict The Risk Factors In Postoperative Early And Mid-stage Cervical Squamous Cell Cancer

OBJECTIVE:In order to predict and screen out the patients who need adjuvant radiotherapy after surgery,and look for indicators to predict the risk factors of postoperative early and mid-stage cervical squamous carcinoma, this study was to investigate the predictive value of SCC-Ag and CYFRA21-1 for the risk factors in postoperative early and mid-stage cervical squamous cell cancer。METHODS:260 patients in stage IA to IIB cervical squamous cell carcinoma operated in The Affiliated Tumor Hospital of Guangxi Medical University from March 2012 to August 2014 enrolled in this study were received the detection of SCC-Ag and CYFRA21-1 expression levels before surgical treatment. Setting up the prediction models through the ROC curve respectively for 185 patients in stage IA to IIB,162 patients in stage IA to IIA and 75 patients in IA to IIA non-bulky cervical squamous cell carcinoma to determin the best predicted value,and verifying the prediction model through 75 patients in stage IA to IIB, 71 patients in stage IA to IIA and 44 patients in IA to IIA non-bulky cervical squamous cell carcinoma.RESULTS:1、The probability of the patients who need the postoperative radiotherapy in the normal group is 27.96%,the SCC-Ag group is 79.41%,the CYFRA21-1group is 60.87%,the very high-risk group is 93.10%.2、Univariate analysis showed that: the risk factor of serum SCC-Ag values in tumors>4cm, myometrial invasion> 1/2 and lymph node metastasis is 5.254、18.657 、 6.173 respectively; the risk factor of serum CYFRA21-1 values in tumors>4cm is 4.518. Multivariate analysis showed that: tumor size, depth of myometrial invasion and lymph node metastasis are independent risk factor of serum SCC-Ag values, the difference was statistically significant(P <0.05);Tumor size is an independent risk factor of serum CYFRA21-1 values, the difference was statistically significant(P <0.05);3、Setting up the prediction models through the ROC curve respectively for185 patients in stage IA to IIB,the area under the ROC curve of SCC-Ag was0.804, the best diagnostic cut-off point is 1.460 ng/ml(the sensitivity and the specificity was 0.608 and 0.94, respectively). The area under the ROC curve of CYFRA21-1 was 0.736, the best diagnostic cut-off point is 2.975 ng/ml(the sensitivity and the specificity was 0.520 and 0.807, respectively).When using the KAPPA test methods with 75 patients in stage IA to IIB cervical squamous cell carcinoma, the above results are verified. And we found that when SCC-Ag is greater than 1.460 ng / ml,the predict sensitivity is 71.1%, and the specificity is100%(Kappa=0.708>0.7).4、Excluding 23 patiens in stage IIB,and setting up the prediction models through the ROC curve respectively for 162 patients in stage IA to IIA2,the area under the ROC curve of SCC-Ag was 0.781, the best diagnostic cut-off point is 1.460 ng/ml(the sensitivity and the specificity was 0.593 and 0.938,respectively). The area under the ROC curve of CYFRA21-1 was 0.698, the best diagnostic cut-off point is 2.975 ng/ml(the sensitivity and the specificity was0.469 and 0.802, respectively).When using the KAPPA test methods with 71 patients in stage IA to IIA2 cervical squamous cell carcinoma, the above results are verified. And we found that when SCC-Ag is greater than 1.460 ng / ml,the predict sensitivity is 81.8%, and the specificity is 100%(Kappa=0.714>0.7.5 、 Excluding 45 patiens in stage ⅠB2 、 ⅡA2, and setting up the prediction models through the ROC curve respectively for 107 patients in stage IA to IIA2 non-bulky cervical squamous cell carcinoma,the area under the ROC curve of SCC-Ag was 0.856, the best diagnostic cut-off point is 1.425 ng/ml(the sensitivity and the specificity was 0.714 and 0.937, respectively). The area under the ROC curve of CYFRA21-1 was 0.600, the best diagnostic cut-off point is3.210 ng/ml(the sensitivity and the specificity was 0.357 and 0.848,respectively).When using the KAPPA test methods with 44 patients in stage IA to IIA2 non-bulky cervical squamous cell carcinoma, the above results are verified. And we found that when SCC-Ag is greater than 1.460 ng/ml,the predict sensitivity is 70.0%, and the specificity is 100%(Kappa=0.783>0.7.CONCLUSION1、Serum SCC-Ag and CYFRA21-1 value are Closely with the postoperative risk factors in early and mid-stage cervical squamous carcinoma.And among them,the tumor size, depth of myometrial invasion and lymph node metastasis are independent risk factor of serum SCC-Ag values.2、Serum SCC-Ag, CYFRA21-1 have significant predictive value for the patients who have the postoperative risk factors in stage IA to IIB,stage IA to IIA and stage IA to IIA non-bulky cervical squamous cell carcinoma.