Systemic inflammation indices and serum squamous cell carcinoma (SCC) antigen: an exploratory analysis on prognosis of patients with vulvar squamous cell carcinoma
Year: 2025
Type: article
Study design: Observational Study
Abstract: • Elevated SCC-Ag levels correlate with lymphopenia and high tumor grade in VSCC. • The combination of SCC-Ag and NLR improves postoperative prognostic discrimination. • Simple inflammatory indices may enhance risk stratification in vulvar cancer. • SCC-Ag elevation reflects a more immunosuppressive systemic profile. • Integrating hematologic and serum biomarkers could guide tailored surveillance. To explore the relationship between hematologic inflammatory indices, serum squamous cell carcinoma antigen (SCC-Ag), and clinicopathological features in vulvar squamous cell carcinoma (VSCC). Twenty-seven women with primary vulvar squamous cell carcinoma were prospectively analyzed. Peripheral leukocyte subsets and derived ratios, including neutrophil-to-lymphocyte (NLR), lymphocyte-to-monocyte (LMR), and eosinophil-to-lymphocyte ratio (ELR), were assessed preoperatively. SCC-Ag was measured in 16 patients and analyzed using a 1.9 ng/mL cut-off. Associations with tumor grade, recurrence, and mortality were investigated through non-parametric tests and ROC analysis. Patients with SCC-Ag ≥ 1.9 ng/mL showed significantly lower lymphocyte counts (1.66 vs. 2.41 × 10 3 /µL, p = 0.021) and higher tumor grade (median G3 vs. G2, p = 0.035), along with trends toward higher NLR and lower LMR. No significant differences emerged for other leukocyte subsets or ratios. Logistic regression models revealed that both SCC-Ag and NLR were associated with recurrence and mortality at 12 months. Their combination improved prognostic discrimination, suggesting a potential role for integrated inflammatory markers in risk stratification. Elevated SCC-Ag levels in VSCC are associated with lymphopenia and poor tumor differentiation, reflecting an unfavorable systemic immune profile. The combination of SCC-Ag and inflammatory indices, particularly NLR, may offer a simple and cost-effective tool for postoperative prognostic assessment and surveillance planning.
Source: Gynecologic Oncology Reports
Institution: University of Naples Federico II
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $930
OpenAlex ID: W4417505037