|Table of Contents|

Predictive value of HR-HPV and SCC-Ag assessment during follow-up for recurrence of postoperative cervical cancer



Research Field:
Publishing date:



Predictive value of HR-HPV and SCC-Ag assessment during follow-up for recurrence of postoperative cervical cancer


LIU Yu LI Li CHEN Jiankun GUO Jianxin HAN Jian ZHENG Xiuhui

Department of Obstetrics and Gynecology, Institute of Surgery Research, Third Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China


cervical cancer high-risk human papilloma virus squamous cell carcinoma antigen recurrence

R373.9; R730.43; R737.33

Objective    To explore the value of predicting recurrence of postoperative cervical cancer by monitoring high-risk human papilloma virus (HR-HPV) and squamous cell carcinoma antigen (SCC-Ag) during followingup. Methods    A total of 406 women who underwent radical or subtotal hysterectomy, or cervical conization or radical trachelectomy due to cervical cancer in our department from January 2012 to December 2016 were prospectively enrolled in this study. During the routine follow-up, HR-HPV and SCC-Ag assessment was performed. The relationship of recurrence with HR-HPV and SCC-Ag was analyzed, and the differences of single detection and joint detection were compared in the prediction of recurrence. Results    Compared those unrecurrent patients, those recurrent had higher HR-HPV persistent positive rate (P<0.001), and higher positive rate of SCC-Ag (P<0.001). The patients with pelvic recurrence had a higher persistent positive rate of HR-HPV than those with distant metastasis (P<0.05), but no such difference was seen in the positive rate of SCC-Ag between those with recurrence and with distant metastasis (P>0.05). In the prediction of recurrence of cervical cancer, single detection of HR-HPV had higher sensitivity (57.9%), and single detection of SCCAg showed higher specificity (95.1%)(both P<0.05). Whereas, joint detection of HR-HPV and SCC-Ag obtained higher sensitivity (76.3%) than single detection (P<0.05). Conclusion    Assessment of HR-HPV and SCC-Ag during following-up can warn the recurrence of cervical cancer in a certain extent, and joint detection can improve the sensitivity of prediction.


[1]CHEN W, ZHENG R, BAADE P D, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132. DOI:10.3322/caac.21338.
[2]WALLIN E, FLTER RDESTAD A, FALCONER H. Introduction of robotassisted radical hysterectomy for early stage cervical cancer: impact on complications, costs and oncologic outcome[J]. Acta Obstet Gynecol Scand, 2017, 96(5): 536-542. DOI:10.1111/aogs.13112.
[3]SCHIFFMAN M, WENTZENSEN N, WACHOLDER S, et al. Human papillomavirus testing in the prevention of cervical cancer[J]. J Natl Cancer Inst, 2011, 103(5): 368-383. DOI:10.1093/jnci/djq562.
[4]YIN M, HOU Y, ZHANG T, et al. Evaluation of chemotherapy response with serum squamous cell carcinoma antigen level in cervical cancer patients: a prospective cohort study[J]. PLoS ONE, 2013, 8(1): e54969. DOI:10.1371/journal.pone.0054969.
[5]KREIMER A R, SCHIFFMAN M, HERRERO R, et al. Longterm risk of recurrent cervical human papillomavirus infection and precancer and cancer following excisional treatment[J]. Int J Cancer, 2012, 131(1): 211-218. DOI:10.1002/ijc.26349.
[6]SHENG X, DU X, ZHANG X, et al. Clinical value of serum HMGB1 levels in early detection of recurrent squamous cell carcinoma of uterine cervix: comparison with serum SCCA, CYFRA211, and CEA levels[J]. Croat Med J, 2009, 50(5): 455-464. DOI:10.3325/cmj.2009.50.455.
[7]周司君, 岑尧, 张翠英. HPV检测对宫颈癌复发预测价值研究[J]. 世界最新医学信息文摘(电子版), 2016(93): 27-28.
ZHOU S J, CEN Y, ZHANG C Y. The predictive value of HPV detection for recurrent cervical cancer[J]. World Latest Med Inform (Electron Vers), DOI:10.3969/j.issn.16713141.2016.93.014.
[8]NCCN. NCCN Guidelines Version 2. 2015[S]. Panel members uterine neoplasms. http: //www. nccn. org/professionals/ physician_gls/pdf/uterine.pdf.
[9]CHUNG Y L, HORNG C F, LEE P I, et al. Patterns of failure after use of (18)FFDG PET/CT in integration of extendedfield chemoIMRT and 3Dbrachytherapy plannings for advanced cervical cancers with extensive lymph node metastases[J]. BMC Cancer, 2016, 16: 179. DOI:10.1186/s1288501622260.
[10]曹泽毅. 中华妇产科学[M]. 北京: 人民卫生出版社, 2014: 2201-2211.
CAO Z Y. Obstetrics and gynecology[M].Beijing: People’s Medical Publishing House, 2014: 2201-2211.
[11]HE C, MAO D, HUA G, et al. The hippo/YAP pathway interacts with EGFR signaling and HPV oncoproteins to regulate cervical cancer progression[J]. EMBO Mol Med, 2015, 7(11): 1426-1449. DOI:10.15252/emmm.201404976.
[12]宋丹, 孔为民, 张同庆, 等. 宫颈癌治疗后高危型人乳头瘤病毒转阴与预后关系研究[J]. 中国实用妇科与产科杂志, 2017, 33(9): 975-978. DOI:10.19538/j.fk2017090123.
SONG D,KONG W M,ZHANG T Q, et al. Research on the relationship between the regression of HR HPV and prognosis in the patients with cervical cancer after treatment[J]. Chin J Prac Gynecol Obstetr, 2017, 33(9): 975-978. DOI:10.19538/j.fk2017090123.
[13]NOVENTA M, ANCONA E, COSMI E, et al. Usefulness, methods and rationale of lymph nodes HPVDNA investigation in estimating risk of early stage cervical cancer recurrence: a systematic literature review[J]. Clin Exp Metastasis, 2014, 31(7): 853-867. DOI:10.1007/ s1058501496705.
[14]ZHOU Z, LI W, ZHANG F, et al. The value of squamous cell carcinoma antigen (SCCa) to determine the lymph nodal metastasis in cervical cancer: A metaanalysis and literature review[J]. PLoS ONE, 2017, 12(12): e0186165. DOI:10.1371/journal.pone.0186165.
[15]VALENTI G, VITALE S G, TROPEA A, et al. Tumor markers of uterine cervical cancer: a new scenario to guide surgical practice[J]. Updates Surg, 2017, 69(4): 441-449. DOI:10.1007/s1330401704913.
[16]KOTOWICZ B, FUKSIEWICZ M, JONSKAGMYREK J, et al. The assessment of the prognostic value of tumor markers and cytokines as SCCAg, CYFRA 21.1, IL6, VEGF and sTNF receptors in patients with squamous cell cervical cancer, particularly with early stage of the disease[J]. Tumour Biol, 2016, 37(1): 1271-1278. DOI:10. 1007/s1327701539140.
[17]栾晓梅, 张瑶, 王诗卓,等. 检测血清鳞状细胞癌抗原对宫颈鳞状细胞癌诊治及预后的临床意义[J]. 中华医学杂志, 2012, 92(19):1330-1333.DOI: 10.3760/cma.j.issn.0376 2491.2012.19.010.
LUAN X M,ZHANG Y,WANG S Z,et al. Clinical significance of serum squamous cell carcinoma antigen in the diagnosis, treatment and prognosis of cervical squamous cell carcinoma[J]. Natl Med J China,2012, 92(19):1330- 1333.DOI: 10.3760/cma.j.issn.03762491.2012.19.010.
[18]李群, 刘淑玉, 刘红丽,等. 血清鳞状细胞癌抗原水平变化在诊断子宫颈鳞癌复发中的临床意义[J]. 中华妇产科杂志, 2015,50(2):131-136.DOI: 10.3760/cma.j.issn.0529567x.2015.02.009.
LI Q,LIU S Y,LIU H L,et al. Significance and implication on changes of serum squamous cell carcinoma antigen in the diagnosis of recurrence squamous cell carcinoma of cervix[J].Chin J Obstet Gynecol, 2015,50(2):131-136.DOI: 10.3760/cma.j.issn.0529567x.2015.02.009.
[19]FERRANDINA G, MACCHIA G, LEGGE F, et al. Squamous cell carcinoma antigen in patients with locally advanced cervical carcinoma undergoing preoperative radiochemotherapy: association with pathological response to treatment and clinical outcome[J]. Oncology, 2008, 74(1/2): 42-49. DOI:10.1159/000138979.
[20]SALVATICI M, ACHILARRE M T, SANDRI M T, et al. Squamous cell carcinoma antigen (SCCAg) during followup of cervical cancer patients: Role in the early diagnosis of recurrence[J]. Gynecol Oncol, 2016, 142(1): 115-119. DOI:10.1016/j.ygyno.2016.04.029.
[21]熊翔鹏, 彭冬先, 郭鹏, 等. 液基细胞学、人乳头瘤病毒联合鳞状细胞癌抗原检测在宫颈癌治疗后随访中的价值[J]. 实用医学杂志, 2016, 32(8): 1286-1288. DOI:10.3969/j.issn.10065725.2016.08.026.
XIONG X P,PENG D X,GUO P,et al. The value of liquid based cytology and human papillomavirus combined with squamous cell carcinoma[J]. J Pract Med, 2016, 32(8): 1286-1288. DOI:10.3969/j.issn.10065725.2016.08.026.


Last Update: 2018-06-14