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首页> 外文期刊>Radiation oncology >Pretreatment carcinoembryonic antigen level is a risk factor for para-aortic lymph node recurrence in addition to squamous cell carcinoma antigen following definitive concurrent chemoradiotherapy for squamous cell carcinoma of the uterine cervix
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Pretreatment carcinoembryonic antigen level is a risk factor for para-aortic lymph node recurrence in addition to squamous cell carcinoma antigen following definitive concurrent chemoradiotherapy for squamous cell carcinoma of the uterine cervix

机译：宫颈鳞状上皮癌同时行放化疗后，除鳞状上皮癌抗原外，预处理前癌胚抗原水平是主动脉旁淋巴结复发的危险因素。

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Background To identify pretreatment carcinoembryonic antigen (CEA) levels as a risk factor for para-aortic lymph node (PALN) recurrence following concurrent chemoradiotherapy (CCRT) for cervical cancer. Methods From March 1995 to January 2008, 188 patients with squamous cell carcinoma (SCC) of the uterine cervix were analyzed retrospectively. No patient received PALN irradiation as the initial treatment. CEA and squamous cell carcinoma antigen (SCC-Ag) were measured before and after radiotherapy. PALN recurrence was detected by computer tomography (CT) scans. We analyzed the actuarial rates of PALN recurrence by using Kaplan-Meier curves. Multivariate analyses were carried out with Cox regression models. We stratified the risk groups based on the hazard ratios (HR). Results Both pretreatment CEA levels ≥ 10 ng/mL and SCC-Ag levels < 10 ng/mL (p < 0.001, HR = 8.838), SCC-Ag levels ≥ 40 ng/mL (p < 0.001, HR = 12.551), and SCC-Ag levels of 10-40 ng/mL (p < 0.001, HR = 4.2464) were significant factors for PALN recurrence. The corresponding 5-year PALN recurrence rates were 51.5%, 84.8%, and 27.5%, respectively. The 5-year PALN recurrence rate for patients with both low (< 10 ng/mL) SCC and CEA was only 9.6%. CEA levels ≥ 10 ng/mL or SCC-Ag levels ≥ 10 ng/mL at PALN recurrence were associated with overall survival after an isolated PALN recurrence. Pretreatment CEA levels ≥ 10 ng/mL were also associated with survival after an isolated PALN recurrence. Conclusions Pretreatment CEA ≥ 10 ng/mL is an additional risk factor of PALN relapse following definitive CCRT for SCC of the uterine cervix in patients with pretreatment SCC-Ag levels < 10 ng/mL. More comprehensive examinations before CCRT and intensive follow-up schedules are suggested for early detection and salvage in patients with SCC-Ag or CEA levels ≥ 10 ng/mL.
机译：背景技术要确定宫颈癌的同期放化疗后，癌前胚胎抗原（CEA）水平是主动脉旁淋巴结（PALN）复发的危险因素。方法回顾性分析1995年3月至2008年1月收治的188例宫颈鳞癌患者的临床资料。没有患者接受PALN辐射作为初始治疗。放疗前后测量CEA和鳞状细胞癌抗原（SCC-Ag）。通过计算机断层扫描（CT）扫描检测到PALN复发。我们使用Kaplan-Meier曲线分析了PALN复发的精算率。用Cox回归模型进行多变量分析。我们根据危险比（HR）对风险类别进行了分层。结果预处理CEA水平≥10 ng / mL和SCC-Ag水平<10 ng / mL（p <0.001，HR = 8.838），SCC-Ag水平≥40 ng / mL（p <0.001，HR = 12.551），和SCC-Ag水平为10-40 ng / mL（p <0.001，HR = 4.2464）是PALN复发的重要因素。相应的5年PALN复发率分别为51.5％，84.8％和27.5％。低（<10 ng / mL）SCC和CEA患者的5年PALN复发率仅为9.6％。 PALN复发时，CEA≥10 ng / mL或SCC-Ag≥10 ng / mL与单独的PALN复发后的总体生存率相关。单独的PALN复发后，治疗前CEA水平≥10 ng / mL也与生存有关。结论对于治疗前SCC-Ag水平<10 ng / mL的患者，对于确定的子宫颈SCC，CCA≥10 ng / mL预处理是PALN复发的另一个危险因素。建议在CCRT之前进行更全面的检查，并加强随访，以早期发现和挽救SCC-Ag或CEA水平≥10 ng / mL的患者。

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