Monitoring the course of cervical carcinoma with the squamous cell carcinoma serum radioimmunoassay

Article Abstract:

A test of potential value for monitoring patients with cervical carcinoma (cancer) is described and evaluated. It measures the blood levels of squamous cell carcinoma antigen (SCC), a protein associated with squamous cell carcinoma. Blood samples from 611 gynecologic patients (not all with cancer) were tested, with the patients divided into seven groups according to diagnosis: 117 healthy women; 110 women who were 15 to 21 weeks pregnant; 81 patients with benign gynecologic diseases; 65 with non-squamous-cell gynecologic cancer; 20 with vulvovaginal squamous cell carcinoma or carcinoma in situ; 83 with other cellular abnormalities of the cervix; and 135 with invasive (extensive) cervical cancer. Details regarding the patients' diagnoses are provided. Sixty-two patients with invasive cervical cancer were followed-up after treatment, 22 of whom underwent radical surgery. Thirty had radiation therapy and 10 were treated with chemotherapy. SCC levels were determined regularly. Results showed that 2.4 nanograms per milliliter was a good cut-off level for separating "normal" patients from those with disease. Slightly fewer than 2 percent of the patients in the first four groups had SCC levels higher than the cut-off point. Fifty-three percent of the patients with invasive cervical carcinoma, and 45 percent of those with recurrent disease, had elevated SCC levels. The sensitivity of the test (true positive results) was 53.3 percent, with a specificity (true negative results) of 94.3 percent. Elevations in SCC levels correctly identified 15 of the 20 patients who had recurrent or persistent disease after treatment, with the elevations occurring between 4 and 5 months before cancer was detected clinically. SCC measurement is not suitable for screening patients, but it may be helpful in monitoring the course of cervical cancer in conjunction with regular physical examinations. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Squamous cell carcinoma antigen

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Human papillomavirus genotype as a prognostic indicator in carcinoma of the uterine cervix

Article Abstract:

Evidence is mounting supporting the role of the human papillomavirus (HPV) infections in causing cancer of the cervix. The HPV has been found in many cervical tumors and can transform rat cells in laboratory studies. There are 55 types of HPV, with types 16, 18 and 31 present most often in cervical tumors. The characteristics of invasive cancer of the cervix vary. The prognosis depends on the cell type, the extent of cancer invasiveness and the spread to neighboring lymph nodes. The effect the presence HPV has on the prognosis of cancer of the cervix was studied in 100 women. HPV types 6, 11, 16, 18, and 31 were isolated from 64 tumors. HPV type 16 was the most common cell type, found in 46 out of 100 tumors. There was no difference among the 69 stage Ib tumors with respect to the size, invasiveness and lymph node involvement in the women with HPV type 16, 18 or those women without HPV. However, 45 percent of the women with HPV 18 (5 out of 11) had tumors return, compared with 16 percent (5 out of 31) of the women with HPV 16. Patients with HPV 18-containing tumors were more likely to have had a recent normal (class I) Pap smear (a routine screening test to detect abnormal cells of the cervix) in the three years preceding the cancer diagnosis; 44 percent of the women with HPV 18 had a history of normal Pap tests, compared with only 16 percent of the women with HPV 16. It is concluded that HPV 18 does not have a prolonged pre-invasive period and is much more aggressive than HPV 16. It is suggested that screening for HPV 18 might help identify women at greater risk for invasive cervical cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Physiological aspects, Papillomaviruses, Papillomavirus, Identification and classification, Pap test, Viral carcinogenesis

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Adenosquamous carcinoma of the cervix: prognosis in stage IB

Article Abstract:

The two most common types of cancer of the cervix are squamous cell carcinoma and adenocarcinoma. Adenosquamous carcinoma is a third type of cancer that involves characteristics of both squamous cell carcinoma and adenocarcinoma. It is unclear whether the prognosis of women having the mixed variety, adenosquamous carcinoma, is more similar to adenocarcinoma or to squamous cell carcinoma. To help clarify this controversial issue, the records of 29 women with stage IB primary adenosquamous cancer of the cervix were reviewed. Out of the 29 patients, 26 (90 percent) had tumors measuring no more than three centimeters (1.2 inches). The overall disease-free five-year survival rate was 85 percent. Of the 19 patients who had their pelvic lymph nodes examined during surgery, three (16 percent) had evidence of cancer spread (metastasis). Of the women with lymph node metastasis, one died eight months after radiation therapy and two are alive three and five years later. There was no difference in the rate of cancer spread to the lymph nodes, recurrence rate, or five-year disease-free survival between the patients with adenosquamous carcinoma (stage IB, tumors less than 3 cm) and a comparison group of 58 women with pure squamous cell carcinoma. It is concluded that patients with stage IB adenosquamous carcinoma of the cervix do not have different potential for cancer spread, or disease outcome, than patients with the more common pure squamous cell carcinoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Squamous cell carcinoma, Adenocarcinoma

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