The Level of Squamous Cell Carcinoma Antigen and Lymph Node Metastasis in Locally Advanced Cervical Cancer

Background: This study aimed to determine the utility and a cut-off level of serum squamous cell carcinomaantigen (SCC-Ag) to predict lymph node metastasis in locally advanced cervical cancer cases. We also investigatedthe correlation between SCC-Ag level and lymph node status. Materials and
Methods: From June 2009 to June2014, 232 patients with cervical cancer stage IB2-IVA, who were treated at Ramathibodi Hospital, were recruited.Receiver operating characteristic (ROC) curves were used to identify the best cut-off point of SCC-Ag level topredict lymph node metastasis. Quantile regression was performed to evaluate the correlation between SCC-Aglevels and pelvic lymph node metastasis, paraaortic lymph node metastasis, and parametrial involvement as wellas tumor size.
Results: Pelvic lymph node metastasis and paraaortic lymph node metastasis were diagnosed in46.6% and 20.1% of the patients, respectively. The median SCC-Ag level was 6 ng/mL (range, 0.5 to 464.6 ng/mL). The areas under ROC curves between SCC-Ag level and pelvic lymph node metastasis, paraaotic lymphnode metastasis, parametrial involvements were low. SCC-Ag level was significantly correlated with paraaorticlymph node status (p=0.045) but not with pelvic lymph node status and parametrial involvement. SCC-Ag levelwas also related to the tumor diameter (p<0.05).
Conclusions: SCC-Ag level is not a good predictor for pelvicand paraaortic lymph node metastasis. However, it is still beneficial to assess the tumor burden of squamouscell carcinoma of the cervix.