【作者】 张丹；

【导师】 唐良萏；

【作者基本信息】 重庆医科大学 ， 妇产科学， 2013， 硕士

【摘要】 目的：探讨鳞状细胞癌抗原（SCC-Ag）在宫颈鳞癌中的临床应用价值及其与疾病类型、肿瘤分期、肿瘤细胞分化、HPV感染及盆腔淋巴结转移的关系。方法：回顾性的分析2011年1月-2012年12月就诊于我科的宫颈病变患者共722例，收集其临床资料，测定血清SCC-Ag浓度。根据不同的临床研究因素进行分组。利用统计学方法分析比较血清SCC-Ag的水平及与疾病类型、肿瘤分期、肿瘤细胞分化、HPV感染及盆腔淋巴结转移的关系。结果：1.SCC-Ag在宫颈癌与宫颈上皮内瘤变患者中的阳性率有明显差异（P=0.003），SCC-Ag在宫颈癌中的水平高于宫颈上皮内瘤变（P<0.0001）。2.宫颈浸润癌患者治疗前的血清SCC-Ag水平与临床分期(P<0.0001)有关，且其浓度随着疾病的进展而升高（P<0.0001）。3.治疗前的SCC-Ag与病理类型有关(P<0.0001)，在鳞癌中的浓度高于腺癌（P<0.0001）。4.盆腔淋巴结转移者治疗前SCC-Ag浓度明显高于无盆腔淋巴结转移者(P<0.0001)。5.HPV感染并不增加治疗前SCC-Ag的阳性率(P>0.05)。结论：1.鳞状细胞癌抗原(SCC-Ag)是可以作为一个宫颈癌特别是宫颈鳞癌的血清肿瘤标志物。2.SCC-Ag可以作为子宫颈癌的辅助诊断指标；且在判断临床分期、宫旁浸润等具有一定的参考价值。3.治疗前的SCC-Ag水平异常升高可以帮助预测盆腔淋巴结转移。4.SCC-Ag在疾病治疗过程中可以一定程度上反映疾病的变化及疗效，帮助制定个体化的治疗方案，减少不必要的副作用。5.在随访过程，SCC-Ag可以反映病情变化，早期发现复发、转移。更多还原

【Abstract】 Objective：To evaluate the value of determination of Serum squamouscell carcinoma antigen(SCC-Ag) levels in cervical cancer，and to find outfactors associated with SCC-Ag.Methods：We observed seven hundred and twenty-two patients whowere registered in department of gynecology in the First AffiliatedHospital of Chongqing Medical University during January2011toDecember2012.They were all diagnosed as cervical lesions (ranging CINto invasive cervical cancer). All the patients had the test of the serumSCC-Ag before any treatment. Then, they were separated into differentgroups according to different clinical parameters. The parameters includestype of disease, tumor clinical stage, tumor cell differentiation, the state ofHPV infection and pelvic lymph node metastases.In order to find out therelationship among SCC-Ag and these parameters，we analyze the datas byusing statistical software（SPSS19）.Results: The serum SCC-Ag level shows a significant differenceamong different clinical stage (P <0.001) and different the pathological type (P <0.0001) in patients with cervical cancer before treatment. Elevatedpretreatment-SCC-Ag level indicates pelvic lymph node metastasis (P<0.0001). There is no significant relationship between HPV infection andelevated pretreatment-SCC-Ag level (P>0.05).Conclusion：SCC-Ag is a specifict tumor marker of cervical cancer，especially squamous cell carcinoma．It can be used as a diagnostic markerwhen diagnosis cervical cancer, and it plays an important role in monitoringthe disease course. It can predict lymph node metastasis and recurrence ofdisease.更多还原