The prognostic value of TPA and SCC in squamous cell carcinoma of the cervix.

Three hundred two patients with squamous cell carcinoma of the cervix had pretreatment measurement of serum levels of tissue polypeptide antigen (TPA) and squamous cell carcinoma antigen (SCC) to assess their prognostic value. Both markers were of prognostic significance in relation to stage, recurrence, and poor survival. The addition of TPA to SCC did not increase the percentage of patients with elevated pretreatment tumor marker level nor improve the prognostic significance. One hundred thirty-five of these patients also had serial assay of both markers during follow-up. Rise from normal or persistently elevated markers after treatment was associated with recurrence. The median lead time to recurrence was 2 months for SCC and 2.5 months for TPA. The addition of TPA to SCC in serial monitoring increased the sensitivity of detection of recurrence but decreased its specificity. The cost of assay of two markers over one may not justify the slight improvement in sensitivity of detection of recurrence. For squamous cell carcinoma of the cervix, SCC is a better tumor marker than TPA.