The assessment of the prognostic value of tumor markers and cytokines as SCCAg, CYFRA 21.1, IL-6, VEGF and sTNF receptors in patients with squamous cell cervical cancer, particularly with early stage of the disease

Abstract

The aim of this study is to determine the prognostic value of tumor markers, as squamous cell carcinoma antigen (SCCAg) and cytokeratin-19 fragment (CYFRA 21.1) and interleukin 6 (IL-6), vascular endothelial growth factor (VEGF), soluble tumor necrosis factor receptor I (sTNF RI), and sTNF RII in patients with squamous cell carcinoma of the cervix. The subjects of analysis were 138 patients with stage I–IVA according to the International Federation of Gynecology and Obstetrics (FIGO) classification. The collected research material comes from one oncology center. During the 10 years of follow-up, 56 relapses and 53 deaths were observed, and recurrent disease in early stage was confirmed in 45 % of patients. The pretreatment serum levels of SCCAg and CYFRA 21.1, and cytokines IL-6, VEGF, sTNF RI, and sTNF RII were determined in all patients. The probability of disease-free survival (DFS) and overall survival (OS) was evaluated using the log-rank test and the Cox regression model. Based on the ROC curve analysis for patients with recurrence, the largest area under the curve was demonstrated for SCCAg and IL-6 and for patients who died, for SCCAg and VEGF. Cox analysis demonstrated that independent prognostic factor for DFS was only SCCAg and for OS cytokine IL-6 and SCCAg, but in patients with early stage the prognostic value for DFS was VEGF, whereas IL-6 and CYFRA 21.1 for OS. Serum level of VEGF, CYFRA 21.1 and IL-6 before treatment in patients with early stage cervical cancer appears to be an important prognostic factor.

The association between serum squamous cell carcinoma antigen and recurrence and survival of patients with cervical squamous cell carcinoma: A systematic review and meta-analysis

“…Some studies reported probability of outcome occurrence or median survival, leaving 44 studies for final pooling of association effects. Among these 44 studies, 31 [14,15,19,21,23, and 26 [14,22,23,28,30,36,37,39,[42][43][44][45][46][47][48][50][51][52][53][54][55][56][57][58][59][60] assessed association effects of pretreatment serum SCC-Ag on recurrence and death outcomes respectively, while 8 [9,19,[23][24][25]31,61,62] and 4 [23,24,60,62] assessed posttreatment SCC-Ag effects on these corresponding outcomes.…”

“…Among 31 studies assessing association between pretreatment serum SCC-Ag and recurrence, 14 [15,21,[28][29][30][32][33][34][35]38,43,45,48,49] and 18 [14,19,28,[37][38][39][40][41][42][43][44][45][46][47][48]50,51,53] assessed high versus low SCC-Ag providing frequency data and HR, respectively; whereas 8 [19,21,29,30,32,36,48,52] studies compared mean SCC-Ag between groups.…”

“…A total of 26 studies assessed the association between pretreatment serum SCC-Ag and the death outcome. Among them, 21 [14,22,28,39,[43][44][45][46][47][48][50][51][52][53][54][55][56][57][58][59][60] and 5 [30,45,48,54,58] studies assessed risk effects where data were sufficient for pooling with HRs and frequency data, respectively, whereas 3 [30,36,44] studies compared mean SCC-Ag between death and survival groups.…”

“…Among 21 studies reporting HR, 4 studies [45,48,56,59] assessed SCC-Ag effect without cutoff, whereas 17 studies assessed high versus low SCC-Ag (cutoff from 1.3 to 40 ng/mL), but 2 studies [39,43]did not report 95%CI, leaving 15 studies [14,22,28,44,46,47,[50][51][52][53][54][55]57,58,60] for final pooling, see Supplementary Table S10. The HRs were highly heterogeneous across the studies (I 2 = 81.6%, Chi-squared = 76.05, d.f.…”

Peripheral blood circulating microRNA‐4636/−143 for the prognosis of cervical cancer

“…6 However, these methods are traumatic and costly. 7,[9][10][11] Thus, studying the peripheral blood circulating microRNAs (miRNAs) has important clinical value for the treatment, diagnosis and prognostic value of cervical cancer. 8 Biomarkers such as tissue polypeptide antigen (TPA), squamous cell carcinoma antigen (SCC-Ag), vascular endothelial growth factor (VEGF), and carcinoembryonic antigen (CEA) are confined to specific types of the cervical cancer but lack sensitivity and specificity.…”