In the present study we reappraised the utilities of squamous cell carcinoma antigen (SCCAg) for the initial diagnosis, the efficacies of treatments and the prediction of recurrence, regarding 346 cases of the primarily-untreated head and neck squamous cell carcinoma (HNSCC) and 136 cases assigned as the negative control.
First, we statistically re-determined the cut-off value of serum SCCAg 2.0ng/ml.
At the initial diagnosis the mean level in the group with more than 2.0ng/ml SCCAg of HNSCC was significantly statistically different from that in the group with less than 2.0ng/ml. Furthermore, the 3-year cause-specific survival rates between the two groups also had significant statistical difference.
The levels were found to increase gradually with staging, and the sensitivity for Stage III + VI was significantly higher than that for Stage I + II. Regarding the histopathological differentiation of HNSCC, cases diagnosed as the well type were measured with higher mean levels. As to the 6 primary lesions of HNSCC, the mean levels in nasopharynx, mesopharynx, and maxillary sinus cancers were more than 2.0ng/ml, and the sensitivities in hypopharynx, mesopharynx, and maxillary sinus cancers were all counted higher than 50%. But in larynx cancer both data were shown as the lowest among the 6 lesions.
In the 83 recurrent cases, all of which were measured with serum SCCAg at the three therapeutic points of the first visit, the end of the initial treatments, and the recurrence, had significant statistical differences among the mean serum levels of the antigen. Especially at the point of the recurrence the serum levels and the sensitivities rose significantly higher than those at the end of the initial treatments. Therefore, strong suspicion of the recurrence should be mandatory for the rise of serum SCCAg with more than 2.0ng/ml in the prognosis after the initial treatments.
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