Journal of Gynecologic Oncology

Korean Society of Gynecologic Oncology (대한부인종양학회)
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Correlation between SCC antigen and the prognosis of cervical cancer patients following concurrent chemoradiotherapy

동시 항암화학방사선 치료를 받은 자궁경부암 환자에서 squamous cell carcinoma antigen과 예후와의 상관관계

Park, Soo-Hyeon;Kim, Young-Tae;Kim, Jae-Wook;Kim, Jae-Hoon;Kim, Sung-Hoon;Yoon, Bo-Sung;Kim, Sang-Wun
박수현;김영태;김재욱;김재훈;김성훈;윤보성;김상운

  • Published : 2005.06.20
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Abstract

Objective : The aim of this study was to determine the correlation between SCC Ag and the prognosis in cervical cancer patients following concurrent chemoradiotherapy (CCRT). Methoda : The charts of 116 patients following concurrent chemoradiotherapy among 330 patients diagnosed to cervical cancer at Yonsei University Medical Center from Jan. 1998 to June 2003 were reviewed retrospectively. Clinical characteristics (age, parity, body mass index), stage, lesion size, cell type, squamous cell subtype, initial SCC Ag (<1.5 and $\geq$ 1.5). posttreatment SCC Ag (<1.5 and $\geq$ 1.5) was evaluated with overall survival. Distribution of SCC Ag level before CCRT in relation to FIGO stage and failure pattem in SCC positive patients before CCRT were reviewed. Overall survival was estimated according to respectivelay, subgroups of initial SCC Ag, SCC Ag after $2^{nd}$ CCRT and posttreatment SCC Ag, Chi square test and Kaplan Meier test were used for statistical analysis (P<0.05). Results : Overall survival was significantly correlated with only stage (P=0.0014). Two patients (15.4%) among 13 patients with recurrence had SCC Ag<1.5. Subgroups (1.5 $\leq$ SCC Ag < 5 ng/m, 5 ng/mL $\leq$ SCC Ag < 30 ng/mL, 30 ng/mL $\leq$ SCC Ag) of initial SCC Ag, SCC Ag after $2^{nd}$ CCRT, and posttreatment SCC Ag were significantly correlated with overall survival (P=0.0337, 0.0001, 0.0446, respectively). Conclusion : The measurements of the levels of initial SCC Ag, SCC Ag after $2^{nd}$ CCRT and posttreatment SCC Ag are expected to be useful in predicting the prognosis of the patients with cervical cancer.

목적 : 본 연구는 동시 항암 화학 방사선 치료를 받은 자궁경부암 환자에서 squamous cell carcinoma antigen (SCC 항원)과 예후의 상관 관계를 규명하기 위해 시도되었다. 연구 방법 : 연세대학교 의과대학 산부인과에서 1998년 1월부터 2003년 6월까지 자궁경부암을 진단 받은 330명의 환자 중에서 동시 항암 화학 방사선 치료를 받은 116명을 대상으로 나이, 산과력, 체질량 계수 등의 일반적 특성을 조사하였고, 병기,병소 크기,세포 형태,편평 세포의 아형,재발 유무,치료 전 SCC 항원(<1.5 ng/mL and $\geq$1.5 ng/mL), 치료 종결 후 SCC 항원(<1.5 ng/mL and $\geq$1.5 ng/mL)에 따른 무병 생존율을 조사하였다. 치료 전 SCC 항원 수치에 따라 FIGO 병기의 분포를 알아보았고 국소 재발이나 원격 전이가 발생한 환자 군에서 초기 SCC 항원 수치에 따른 분포를 살펴보았다. 초기 SCC Ag, $2^{nd}$ 동시 항암 화학 요법이 끝난 후의 SCC 항원, 치료 종결 후의 SCC 항원이 1.5 ng/mL 이상인 군에서 각각 5 ng/mL 미만, 5 ng/mL 이상 30 ng/mL 미만, 30 ng/mL 이상으로 나누어 무병 생존율에 차이가 있는지 알아보았다. 통계 학적인 방법은 chi square test와 Kaplan Meier test를 이용하였고 p 값은 0.05 미만일 때 유의한 것으로 보았다. 결과 : 자궁경부암의 병기는 무병 생존율과 유의한 상관 관계를 보였다(P=0.0014). 재발한 13명 중 초기 SCC 항원이 1.5 ng/mL 미만인 환자는 2명(15.4%)이었다. 초기 SCC 항원, $2^{nd}$ 동시 항암 화학 방사선 치료 후의 SCC 항원과 치료 종결 후의 SCC 항원이 1.5 ng/mL 이상으로 증가된 군에서 각각의 SCC 항원에 따른 세 군(1.5 ng/mL$\leq$SCC Ag<5 ng/mL, 5 ng/mL$\leq$ SCC Ag<30 ng/mL, 30 ng/mL$\leq$SCC Ag)에 무병 생존율은 의미 있는 차이를 보였다(각각 P=0.0337, 0.0001, 0.0446). 결론 : 동시 항암 화학 방사선 요법을 받은 자궁경부암 환자에서 초기 SCC 항원, $2^{nd}$ 동시 항암 화학 방사선 치료 후의 SCC 항원과 치료 종결 후의 SCC 항원 측정은 예후를 예측하는데 유용하리라 사료된다.

Keywords

References

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