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Diagnostic Value of SCC-Ag Combined With CYFRA 21-1 in Predicting Long-Term Lymph Node Metastasis After Cervical
1Department of Comprehensive Oncology V, Shandong Public Health Clinical Center, 250000 Jinan, Shandong, China.
Aims/Background:
Lymph node metastasis (LNM) is an important prognostic factor of cervical cancer, significantly impacting patient outcomes and treatment strategies. Current methods for predicting LNM after surgery are limited, necessitating the identification of reliable biomarkers. This study aimed to evaluate the diagnostic value of serum squamous cell carcinoma antigen (SCC-Ag) combined with cytokeratin fragment 21-1 (CYFRA 21-1) for identifying long-term LNM after cervical cancer surgery.
Methods:
A retrospective case-control study was conducted on 138 patients with primary cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy between May 2020 and May 2023. Patients were followed up for at least two years post-surgery, with a focus on their LNM status. Serum SCC-Ag and CYFRA 21-1 levels were measured using an electrochemiluminescence immunoassay analyzer. Patients were classified into two groups based on the presence of LNM detected during follow-up: without LNM and with LNM groups. The cohort was further divided into a training set (n = 85) and a test set (n = 53). Univariate and multivariate logistic regression analysis identified significant predictors, which were used to construct a nomogram diagnostic model. Model performance was evaluated using calibration curves, receiver operating characteristic curve analysis, and decision curve analysis.
Results:
Elevated serum SCC-Ag and CYFRA 21-1 levels were observed in patients with LNM compared to those without. Multivariate logistic regression identified both of these markers as independent predictors of long-term LNM (all p < 0.05). The constructed nomogram model integrating these markers demonstrated high discriminatory power, with an area under the curve of 0.869 in the training set and 0.861 in the test set.
Conclusion:
Serum SCC-Ag and CYFRA 21-1 levels may serve as valuable biomarkers for predicting long-term LNM after cervical cancer surgery. A nomogram model integrating these markers provides enhanced diagnostic accuracy and could potentially guide personalized treatment strategies.
