Clinical evaluation of serum and immunohistochemical expression of SCC and CA19-9 in radiation therapy for cervical cancer.

The prognostic significance of serum level of SCC and CA19-9 (i.e. sr-SCC and sr-CA19-9) and tumor expression of SCC and CA19-9 (i.e. im-SCC and im-CA19-9) were investigated in patients undergoing radiation therapy for cervical cancer. A total of 103 patients comprising 95 squamous cell carcinomas, 3 adenosquamous cell carcinomas and 5 adenocarcinomas, were studied. The tumor expression of SCC and CA19-9 were determined immunohistochemically. The positivity of the patients with abnormal sr-SCC levels for squamous cell carcinoma, adenosquamous cell carcinoma and adenocarcinoma were 87.7%, 50.0% and 40.0%, respectively The 5-year-survival rates of sr-SCC positive and negative patients were 71.1% and 100%, respectively (P > 0.1). The survival rates of im-SCC positive and negative patients were 70.0% and 80.7%, respectively (P > 0.1). The positivity of patients with im-CA19-9 in squamous cell carcinoma, adenosquamous cell carcinoma, im-CA19-9 adenocarcinoma were 29.1%, 66.6%, and 100%, respectively. The 5-year-survival rates of sr-CA19-9 positive patients was 62.5%, poorer than the 77.6% of negative ones (P < 0.1). The survival rate of im-CA19-9 expression positive patients was 92.0%, significantly better than the 70.7% in negative patients (P < 0.05). Although the sr-SCC level just at the end of radiation therapy was not correlated with local control, re-elevation of the SCC was highly associated with early relapse. These results suggested that follow-up of patients by periodical serum examination for these tumor markers is highly useful for the early detection of tumor relapse.