Predictive Value Of Serum Squamous Cell Carcinoma Antigen For The Exact Disease Degree In Patients With Colposcopically Diagnosed Cervical Intraepithelial Neoplasia

Objective: To investigate whether the level of serum squamous cellcarcinoma antigen(SCC-Ag) could help to screen the insidious invasivecarcinoma in patients with cervical intraepithelial neoplasia（CIN）II-IIIdiagnosed through colposcopically directed biopsy.Methods: Serum SCC-Ag level was detected in255CINII-III patientsdiagnosed by biopsy under colposcopy and admitted to our hospital.Conization or hysterectomy was performed after informed consent wassigned. Based on the final pathological results, these255CIN patients weredivided into four groups: CINⅠgroup (n=5) and CINⅡ-Ⅲ group (n=212);micro-invasive carcinoma group (n=16) and invasive carcinoma group(n=22). We compared the levels of preoperative serum SCC-Ag among eachgroup to testify whether it could predict the lesion degree of these patients,so as to justify the reasonability of conization or hysterectomy for eachcolposcopically diagnosed CIN II-III patients. Results: Serum SCC-Ag level appeared to be related with the degreeof disease in patients with colposcopically diagnosed CINII-III. Thepreoperative serum SCC-Ag level in those with more serious disease testedpostoperatively was higher than those with the same degree disease (P=0.002), and the levels of SCC-Ag with microinvasive or invasive diseaseswere obviously higher than those of the CIN disease (P=0.016), especiallyin the invasive carcinoma group (P=0.014). The positive rates ofpreoperative serum SCC-Ag in the four groups were0.0%(0/5),32.5%(69/212),37.5%(6/16),54.5%(12/22) respectively, suggesting thecorrelation between the true degree of disease and the positive rates ofpreoperative serum SCC-Ag, although there was no statistical differencewith chi-square statistics (X2=6.988, P=6.988) probably because oflimited case number. The optimal cut-off critical value of serum SCC-Ag inpredicting the more severe degree of postoperative pathological changes inpatients with CIN was1.25ng/mL (sensitivity:71.4%andspecificity:60.1%). The predicted specificity could reach80%with the setlevel of serum SCC-Ag≥2.05ng/mL.Conclusions: Serum level of SCC-Ag has certain predictive value forthe exact disease degree in patients with colposcopically diagnosedCINII-III. It appears to function as a means to screen invasive cervicalcarcinoma hidden in these patients, so as to help practitioners for theirdecision-making as for the optimal choice of conization or hysterectomy.