Research Article| Volume 159, ISSUE 2, P394-398, December 2011

Download started.


Use of squamous cell carcinoma antigen as a biomarker of chemotherapy response in patients with metastatic cervical carcinoma



      To examine the use of squamous cell carcinoma antigen (SCCA) as a biomarker of chemotherapy response in patients who underwent chemotherapy for metastatic cervical carcinoma.

      Study design

      The study population consisted of patients who underwent first-line chemotherapy for metastatic cervical carcinoma between 1999 and 2009. SCCA levels were serially measured before, during and after chemotherapy. Radiographic responses were evaluated according to the criteria of the World Health Organization. A logistic model was used to determine the best prediction model, and internal and external validation of the prediction model were performed to compare the areas under the receiver operating characteristic curves (AUCs).


      In total, 55 patients were included in the analysis. Data for 32 patients enrolled in various clinical trials were used to develop the prediction model. Patients who achieved a radiographic response showed a significant decline in SCCA levels between the second and third cycles of chemotherapy, whereas patients who did not achieve a radiographic response showed constant SCCA levels over the same period. The prediction model was developed on the basis of changes in the SCCA level between the second and third cycles of chemotherapy (AUC = 0.832) and the baseline SCCA level. The AUC after external validation, calculated using the data of the clinical practice population (n = 22), was 0.871.


      A response to chemotherapy was possible for patients in whom SCCA levels declined between the second and third cycles of chemotherapy.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • Crombach G.
        • Scharl A.
        • Vierbuchen M.
        • Wurz H.
        • Bolte A.
        Detection of squamous cell carcinoma antigen in normal squamous epithelia and in squamous cell carcinomas of the uterine cervix.
        Cancer. 1989; 63: 1337-1342
        • Duk J.M.
        • Groenier K.H.
        • de Bruijn H.W.
        • et al.
        Pretreatment serum squamous cell carcinoma antigen: a newly identified prognostic factor in early-stage cervical carcinoma.
        J Clin Oncol. 1996; 14: 111-118
        • Scambia G.
        • Benedetti Panici P.
        • Foti E.
        • et al.
        Squamous cell carcinoma antigen: prognostic significance and role in the monitoring of neoadjuvant chemotherapy response in cervical cancer.
        J Clin Oncol. 1994; 12: 2309-2316
        • Gadducci A.
        • Tana R.
        • Cosio S.
        • Genazzani A.R.
        The serum assay of tumour markers in the prognostic evaluation, treatment monitoring and follow-up of patients with cervical cancer: a review of the literature.
        Crit Rev Oncol Hematol. 2008; 66: 10-20
      1. World Health Organization. WHO handbook for reporting result of cancer treatment. Offset publication 48. Geneva: World Health Organization; 1979.

      2. International Agency for Research on Cancer. WHO Chron 1969;23:323–6.

        • Harrell Jr., F.E.
        • Lee K.L.
        • Mark D.B.
        Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors.
        Stat Med. 1996; 15: 361-387
        • Ngan H.Y.
        • Wong L.C.
        • Chan S.Y.
        • Ma H.K.
        Use of serum squamous cell carcinoma antigen assays in chemotherapy treatment of cervical cancer.
        Gynecol Oncol. 1989; 35: 259-262
        • Hong J.H.
        • Tsai C.S.
        • Chang J.T.
        • et al.
        The prognostic significance of pre- and posttreatment SCC levels in patients with squamous cell carcinoma of the cervix treated by radiotherapy.
        Int J Radiat Oncol Biol Phys. 1998; 41: 823-830
        • Micke O.
        • Prott F.J.
        • Schafer U.
        • Tangerding S.
        • Potter R.
        • Willich N.
        The impact of squamous cell carcinoma (SCC) antigen in the follow-up after radiotherapy in patients with cervical cancer.
        Anticancer Res. 2000; 20: 5113-5115
        • Ohara K.
        • Tanaka Y.
        • Tsunoda H.
        • Nishida M.
        • Sugahara S.
        • Itai Y.
        Assessment of cervical cancer radioresponse by serum squamous cell carcinoma antigen and magnetic resonance imaging.
        Obstet Gynecol. 2002; 100: 781-787
        • Gadducci A.
        • Tana R.
        • Fanucchi A.
        • Genazzani A.R.
        Biochemical prognostic factors and risk of relapses in patients with cervical cancer.
        Gynecol Oncol. 2007; 107: S23-S26
        • Pras E.
        • Willemse P.H.
        • Canrinus A.A.
        • et al.
        Serum squamous cell carcinoma antigen and CYFRA 21-1 in cervical cancer treatment.
        Int J Radiat Oncol Biol Phys. 2002; 52: 23-32
        • Maiman M.
        • Feuer G.
        • Fruchter R.G.
        • Shaw N.
        • Boyce J.
        Value of squamous cell carcinoma antigen levels in invasive cervical carcinoma.
        Gynecol Oncol. 1989; 34: 312-316
        • Rustin G.J.
        • Marples M.
        • Nelstrop A.E.
        • Mahmoudi M.
        • Meyer T.
        Use of CA-125 to define progression of ovarian cancer in patients with persistently elevated levels.
        J Clin Oncol. 2001; 19: 4054-4057
        • Rustin G.J.
        • van der Burg M.E.
        • Griffin C.L.
        • et al.
        Early versus delayed treatment of relapsed ovarian cancer (MRC OV05/EORTC 55955): a randomised trial.
        Lancet. 2010; 376: 1155-1163