Predictive efficacy of serum SCC-Ag and VEGF in predicting recurrence during mifepristone treatment in patients undergoing laparoscopic myomectomy: A retrospective cohort study

Abstract: Background: Serum squamous cell carcinoma antigen (SCC-Ag) and vascular endothelial growth factor (VEGF) may predict recurrence in patients with uterine fibroids after laparoscopic myomectomy (LM) and mifepristone treatment, but evidence is limited. Objectives: This retrospective cohort study aimed to evaluate whether preoperative serum SCC-Ag and VEGF levels can predict 2-year recurrence in patients with uterine fibroids receiving postoperative mifepristone after LM. Objectives: This study aimed to evaluate whether preoperative serum SCC-Ag and VEGF levels can predict 2-year recurrence in UF patients receiving postoperative mifepristone after LM. Methods: This retrospective study included 110 patients with uterine fibroids who underwent LM followed by 3 months of mifepristone. After a 2-year follow-up, 12 patients (recurrence group) had a recurrence and 98 (non-recurrence group) did not. Serum SCC-Ag, VEGF, estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were measured. Logistic regression, ROC analysis, decision curve analysis (DCA) and subgroup analysis were performed. Results: The recurrence group had significantly higher levels of E2, FSH, LH, SCC-Ag and VEGF (all P<0.05). The largest fibroid diameter (OR=3.142), SCC-Ag (OR=2.338), VEGF (OR=2.461) and E2 (OR=2.457) were independent risk factors. The AUCs for predicting recurrence were 0.796, 0.811, 0.843 and 0.767, respectively. DCA showed positive net benefits across risk thresholds. Subgroup analysis indicated stronger correlations with recurrence in patients with a largest fibroid diameter ≥10 cm, SCC-Ag ≥2.56 ng/mL, VEGF ≥275.34 ng/mL or E2 ≥345.12 pmol/L. Conclusion: Serum SCC-Ag, VEGF, largest fibroid diameter and E2 show good predictive value for early (2-year) recurrence in uterine fibroid patients after LM and mifepristone treatment. Owing to the single-center, retrospective design, small sample size (12 recurrences) and lack of molecular validation, these findings are exploratory and require validation in multicenter, prospective cohorts.