Value of tumor-antigen (TA-4) of squamous cell carcinoma in predicting the extent of cervical cancer

Use of serum squamous cell carcinoma antigen assays in chemotherapy treatment of cervical cancer

Serum squamous cell carcinoma antigen levels of 15 patients with recurrent or progressive squamous cell carcinoma of the cervix on chemotherapy treatment were assayed. In 13 of these 15 patients (86.7%), clinical response was positive correlated with change in serum SCC level. A stationary or rising serum SCC level indicated that the disease is probably stationary or progressive and chemotherapy should be stopped or changed.

Significance of serum SCC antigen as a tumor marker in patients with squamous cell carcinoma of the vulva

The significance of serum SCC antigen as a tumor marker was investigated in 94 women with squamous cell carcinoma of the vulva. The incidence of elevated serum SCC levels varied from 10% in FIGO stage I to 40% in FIGO stage IV. We did not observe a correlation between elevated pretreatment SCC values and the presence of lymph node metastases. During follow-up, elevated serum SCC values were observed in 8 of 19 patients (42%) with recurrent or progressive disease. It is concluded that the determination of serum SCC levels does not provide additional information in the staging of squamous cell vulvar carcinoma, but can be useful for the early detection of recurrent disease during follow-up in some patients. However, elevated serum SCC levels were also found in 25% of patients without demonstrable tumor activity during follow-up and benign skin disorders were recognized as a cause of false-positive SCC results.

Elevated levels of squamous cell carcinoma antigen in patients with a benign disease of the skin

Squamous cell carcinoma antigen (SCC), formerly referred to as TA-4, is a tumor marker for SCC of the uterine cervix. Based on the findings in a patient with complete remission after treatment for cervical carcinoma, the authors decided to analyze the sera from patients with benign dermatoses. It was found that 83% (25/30) of the patients with psoriasis and 80% (12/15) of the patients with eczema had SCC levels in excess of the cut-off value of 2.5 ng/ml. In psoriasis the serum SCC level correlated positively with the body surface area affected by the disease (r = 0.64). Seven patients with miscellaneous skin disorders, all with an inflammatory component, showed high serum SCC levels as well. Thus the existence of an inflammatory skin disease or a hyperkeratotic skin disease with an inflammatory component interferes with the usefulness of the SCC antigen as a tumor marker in SCC of the uterine cervix.

Value of squamous cell carcinoma antigen levels in invasive cervical carcinoma

Squamous cell carcinoma (SCC) antigen (Ag) levels were measured by radioimmunoassay in 64 patients with invasive squamous cell cervical carcinoma and 9 patients with nonsquamous carcinoma before the initiation of treatment. The mean antigen level in the squamous group was 10.5 ng/ml compared with 1.3 ng/ml in the nonsquamous group. In the patients with squamous cell carcinoma, mean SCC Ag level correlated well with stage, except for bulky stage IB tumors (P less than 0.05), where mean level was much higher than expected. Patients with exophytic tumors had significantly higher SCC Ag levels than those with nonexophytic tumors. Follow-up on 62 evaluable patients ranged from 20 to 40 months. The mean pretreatment SCC Ag level for patients free of disease at last contact was 5.6 ng/ml, in contrast to 16.1 ng/ml for those with recurrent disease. Only 32% of patients free of disease had pretreatment levels of 4.0 ng/ml or greater, while 86% of those with recurrent disease had such values (P less than 0.05). Forty patients had follow-up samples drawn 1 to 14 months after treatment. Mean post-treatment SCC Ag levels dropped to 1.8 ng/ml in 21 patients free of disease (73% decrease), but remained elevated at 13.4 ng/ml (17% decrease) in 19 patients with recurrences. The specificity of follow-up SCC Ag levels as a predictive test for outcome was 90%, with a sensitivity of 63%. We conclude that pretreatment SCC Ag levels correlate well with tumor stage, lesion morphology, and extent of disease. SCC antigen levels may be used to follow patients to determine effectiveness of treatment.

Characterization of a newly established, TA-4-producing squamous carcinoma cell line derived from metastatic tongue carcinoma

A human squamous carcinoma cell line was established from the pleural effusion of a patient with recurrent squamous carcinoma of the tongue. The cell line, designated HST-I, has been passaged 82 times over a period of 4 years. The cells have been shown by light and electron microscopy to be of the squamous epithelial type. Immuno-histochemical staining was positive for keratin. When these cells were transplanted into athymic nude mice, tumors developed at the site of inoculation, which on histological examination were shown to be well-differentiated squamous carcinomas. Karyotypic analysis of cells from the cell line demonstrated an aneuploid human type with a modal chromosome number of 71, with both numerical and structural aberrations. HST-1 cells produce and secrete TA-4, a squamous-cell carcinoma-related antigen, in vitro in culture and in vivo in nude mice bearing the tumors produced by inoculation of cultured cells. Thus, the HST-1 cell line represents a new human tongue squamous carcinoma producing TA-4. This cell line appears useful for facilitating therapeutic investigations as well as biological studies on the association between cancerous growth and circulating TA-4 levels.

Serum squamous cell carcinoma antigen levels in patients with invasive squamous vulvar and vaginal cancer: a preliminary report

Pretreatment serum squamous cell carcinoma antigen (SCC) levels were obtained in 12 patients with invasive vulvar and 5 patients with invasive vaginal squamous cancer. Only 4 of 12 (33%) patients with vulvar cancer and 1 of 5 (20%) patients with vaginal cancer, usually those with more advanced disease, had elevated serum SCC levels at the time of diagnosis.

Squamous cell carcinoma radioimmunoassay in squamous cell carcinoma of the head and neck

Tumor-associated antigen has shown promise as a clinical aid in the detection and monitoring of uterine cervical squamous cell carcinoma. Antigen levels have been shown to reflect the extent of disease and response to treatment. These findings have suggested that measurements of tumor-associated antigen may be useful in monitoring other squamous cell carcinomas. To test this hypothesis, we measured tumor-associated antigen using the squamous cell carcinoma radioimmunoassay in 103 patients with previously treated squamous cell head and neck tumors and 28 patients with known squamous cell carcinoma of the head and neck. Increased squamous cell carcinoma antigen levels were found in 39 percent of patients with known tumors and in 19 percent of the patients with previous curative resection. The sensitivity of the assay limited its usefulness in predicting the presence of new and recurrent tumors.

Detection of squamous cell carcinoma antigen in normal squamous epithelia and in squamous cell carcinomas of the uterine cervix

Squamous cell carcinoma (SCC) antigen is a subfraction of tumor antigen TA-4 isolated from a cervical squamous cell carcinoma. The specificity of SCC antigen and the factors influencing its release into serum were evaluated. Antigen concentrations were measured in 157 tissue extracts and in 188 sera of patients with nonmalignant or malignant gynecologic diseases. A commercial radioimmunoassay based on polyclonal antibodies (Abbott Laboratories, North Chicago) was used. Cytosol concentrations were significantly higher (P less than 0.005) in normal squamous epithelia (means = 6040 ng/mg cell protein [CP]) and in squamous cell carcinomas (means = 2483 ng/mg CP) of the exocervix than those in normal columnar epithelia and in adenocarcinomas of the endocervix, endometrium, ovary, and breast (means = 1-508 ng/mg CP). Despite the high antigen concentrations in normal squamous epithelia, elevated serum levels (greater than 2.5 ng/ml) were almost exclusively found in patients with cervical squamous cell carcinomas. The sensitivity of SCC antigen as a marker for primary carcinomas was 61%, increasing from 29% in Stage I to 89% in Stage IV. The positivity rate was higher in women with well-differentiated (78%) and moderately differentiated carcinomas (67%) than in those with poorly differentiated tumors (38%). The results show that SCC antigen is not tumor specific. The release into serum is independent of local tissue content, but is apparently influenced by the infiltrative growth, the mass, and the degree of histologic differentiation of the tumor.

Soluble immune complexes and squamous cell carcinoma-related antigens in patients with head and neck cancer

Sera from 85 patients with head and neck cancer including laryngeal cancer, hypopharyngeal cancer, nasopharyngeal cancer, and maxillary cancer were assayed for immune complexes (IC) by solid-phase anti-C3 enzyme immunoassay and for squamous cell carcinoma-related (SCC) antigen by radioimmunoassay. The positive rates of IC and SCC antigen in head and neck cancer patients were 29.4% and 34.1%, respectively. Their serum levels and positive rates were found to be elevated according to the degree of advancement of the disease stage, showing their good clinical correlations. With individual patients there was no significant relationship between IC and SCC antigen.

Epidermal growth factor receptors in cancer tissues of esophagus, lung, pancreas, colorectum, breast and stomach

The levels of epidermal growth factor (EGF) receptors were investigated in surgically resected tumors of various origins including esophagus (n = 33), lung (n = 14), pancreas (n = 9), colorectum (n = 10), breast (n = 23) and stomach (n = 8). The 125I-EGF binding capacities of squamous cell carcinomas of esophagus and lung were exceptionally higher than those of the other cancer tissues. Immunohistochemical staining with an anti-EGF receptor monoclonal antibody detected EGF receptors in the basal cells and parabasal cells of normal esophageal epithelium and in all the cancer cells of squamous cell carcinoma tissues of esophagus and lung. DNA replicating cells were examined by the bromodeoxyuridine staining method and it was found that the basal cells and parabasal cells of normal epithelium and peripheral cells of cancer pearls are proliferating. Contrary to this, a tumor antigen TA-4, known as a specific marker for squamous carcinoma, was detected in the differentiated cancer cells and in middle-layer squamous cells. These results strongly suggest that the increase in EGF receptor levels may be associated with the development of human squamous cell cancers of esophagus and lung. Thus, measurement of EGF receptor expression in tumor tissues has diagnostic value and should prove useful for the development of new therapies.

Availability of tumor-antigen 4 as a marker of squamous cell carcinoma of the lung and other organs

The serum level of tumor-antigen 4 (TA-4) was measured in 401 patients with squamous cell carcinoma (SCC) of various organs (76 lung, 82 esophagus, and 234 head and neck). The mean serum level of TA-4 in patients with lung SCC was 3.6 times higher than that in healthy controls and even higher in the advanced stages of disease (III, IV). In patients with benign diseases or other types of lung cancer, however, the TA-4 serum level was not different from the controls regardless of the clinical stage. During radiation therapy, the TA-4 levels in patients with lung SCC decreased with reduction in tumor size. It increased again markedly during recurrence. Similarly, patients with SCC of the esophagus and head and neck also showed elevated TA-4 levels but only at advanced stages and in recurrence. It was concluded that TA-4 is highly related to SCC not only of the uterine cervix but also of other organs and that serum level determinations are useful for monitoring therapeutic effects and recurrence of these diseases, despite some limitations.

Increased serum levels of squamous cell carcinoma-related antigen in pemphigus

Serum levels of squamous cell carcinoma-related antigen (SCC-RAG) were measured in five cases of pemphigus, five cases of bullous pemphigoid and 18 cases of benign and malignant dermatoses other than SCC. The SCC-RAG titres were significantly raised in four of five patients with pemphigus, while they remained within the normal range in the other dermatoses except in one case. In three pemphigus cases in whom serial measurements were made, SCC-RAG levels seemed to be related to disease activity. The SCC-RAG levels in blister fluids were much higher than those in serum, suggesting that the skin is a major source of serum SCC-RAG. These results show that SCC-RAG is increased not only in SCC, but also in some cases of pemphigus, and suggest that pemphigus antibodies may cause the production or release of SCC-RAG.

Computed tomography and lymphography in the presurgical staging of early carcinoma of the uterine cervix

The value of bipedal lymphography and computed tomography (CT) in the presurgical staging of early carcinoma of the uterine cervix was analysed in 62 patients by histologic examination of pelvic lymph nodes and parametrial extension at the time of surgery. Macroscopic invasion of the lymph nodes was detected in 33% of the patients by CT and in 17% by lymphography. Microscopic invasion was suspected in 9% by CT scan and in 38% by lymphography. Physical examination with measurement of the tumor diameter was more predictive for regional extension of the disease as compared to lymphography and CT. CT may detect subclinical parametrial invasion but overestimation of the extent of the disease is common. Bipedal lymphography and CT add only limited information to the routine presurgical staging of cancer of the uterine cervix.

An evaluation of squamous cell carcinoma antigen in patients with cervical squamous cell carcinoma

In a prospective study, serum concentrations of squamous cell carcinoma antigen, a subfraction of tumor antigen (TA-4), were determined by radioimmunoassay from healthy donors, pregnant women, and subjects with various benign and malignant gynecologic diseases. Ninety-six percent of 99 healthy persons including all 52 female controls, the 15 pregnant patients, and all 23 subjects with benign gynecologic tumors, had squamous cell carcinoma antigen levels less than 2.0 ng/ml. Seven of 51 (14%) patients with cervical intraepithelial neoplasia and 16 of 24 (67%) patients with cervical squamous cell carcinoma had squamous cell carcinoma antigen levels greater than 2.0 ng/ml. Declining and rising levels of squamous cell carcinoma antigen, which were determined sequentially in nine cases of cervical carcinoma that were associated with elevated pretreatment levels of squamous cell carcinoma antigen, correlated with regression and progression of the disease. Serial serum levels of squamous cell carcinoma antigen provide a noninvasive means of monitoring the effects of individual therapy in patients with cervical squamous cell carcinoma.

Studies on the special tumor marker of cervical cancer of the uterus

Although cervical cancer is the most common malignancy of the gynecologic system, very few tumor markers have been specially prepared for this disease. This article reviews some of the current investigations of those markers, particularly describing TA-4, a tumor antigen of cervical squamous cell carcinoma, which has currently been widely used in clinical practice.

Flow cytometric analysis of tumor antigen TA-4 in cervical cytologic specimens

Flow cytometric analysis of cellular contents of TA-4, a tumor antigen of squamous cell carcinoma, was performed in vaginal smears from 143 women. Abnormal findings, characterized by a cell peak with high fluorescence intensity, appeared in 85.7% of cases (54/63) of cervical squamous cell carcinoma, 80% of cases (4/5) of severe dysplasia, 42.9% of cases (3/7) of mild-to-moderate dysplasia, and in 20.6% of cases of healthy women (13/63). Cellular compositions sorted from abnormal cell fractions with high fluorescence intensity consisted, not only of malignant cells but also of morphologically nonmalignant cells. Immunohistochemical studies indicated that these nonmalignant cells with high TA-4 content originated from the intermediate layer of squamous epithelium adjacent to the cancer nest. These findings indicate that this method may be a useful approach for investigating some biologic characteristics of cells and for detecting cervical cancer or its precursors.

Tumor-antigen TA-4 in the detection of recurrence in cervical squamous cell carcinoma

A radioimmunoassay for a tumor-antigen (TA-4) of squamous cell carcinoma was used to detect the recurrence in patients with squamous cell carcinoma of the uterine cervix. Of 17 patients who had recurrence, 15 cases showed reappearance of serum TA-4 levels. Reappearance of serum TA-4 was faster than other clinical signs of recurrence in 11 cases. These results indicated that TA-4 assay would be a useful aid for the detection of recurrence in cervical squamous cell carcinoma.

Prognostic significance of the tumor antigen TA-4 in squamous cell carcinoma of the uterine cervix

Prognostic values of a tumor antigen (TA-4) of squamous cell carcinoma were studied in 135 patients with invasive squamous cell carcinoma of the uterine cervix. In order to evaluate the host defense responses against cancer, the percentage of lymphocytes (percentages of lymphocytes in total leukocyte counts in the peripheral blood) was also determined simultaneously in each case. All patients were followed up for 2 years. Sixty patients with Stage II disease underwent a radical operative procedure, and all other cases (75 cases) were treated primarily with radiation therapy. In both groups of patients, the survival rate or disease-free rate was significantly worse in those with TA-4 levels of greater than or equal to 15 microunits/ml compared to that of those with lower levels. The prognosis was particularly poor in those patients who had TA-4 levels of greater than or equal to 15 microunits/ml and lymphocyte percentages of less than 30. It was concluded that the simultaneous determinations of serum TA-4 and lymphocyte percentages would be useful in predicting the prognosis of cervical squamous cell carcinoma.