Serum squamous cell carcinoma antigen as a new marker for hepatocellular carcinoma: a preliminary study

Hepatocellular carcinoma [HCC] is the fifth most common malignancy in the world. In Egypt, HCC was reported to account for about 4.7% of chronic liver disease [CLD] patients. Squamous cell carcinoma antigen [SCCA] has been reported to be strongly expressed in HCC tissue. To evaluate the clinical usefulness of serum SCCA levels as a serological marker for early detection of HCC among high risk patients compared to AFP. The study comprised 3 groups. Group [A] included 30 patients with CLD diagnosed on clinical, laboratory and ultrasonographic basis, group [B] included 49 patients with HCC proved by spiral CT, elevated AFP and/or liver biopsy and group [C] included 15 healthy subjects matched for age and sex as a control group. All groups were subjected to thorough history taking, full clinical examinationand laboratory investigations including liver functions, viral markers, AFP and SCCA estimation using ELISA technique. This study revealed a highly significant difference between patients with HCC, CLD and controls regarding serum SCCA level [5.38 +/- 7.689, 1.133 +/- o.516, and 0.787 +/- 0.432 ng/ml respectively]. SCCA level was persistently elevated in patients with HCC with normal APP levels representing its useful role in early detection and follow up of patients treated for HCC. The area under the curve [AUC] of SCCA was 0.869 [95%CI 0.783-0.929], the cut off value was established at 1.5 ng/ml with sensitivity of 77.6%and specificity of 84.4%. The difference between AUC of SCCA and that of AFP was 0.09 which mounted of statistical significance. SCCA could represent a useful tool as a marker for detection of HCC and for monitoring therapy