Evaluation of serum squamous cell carcinoma antigen as a novel biomarker for diagnosis of hepatocellular carcinoma in Egyptian patients

Abstract

BACKGROUND: Hepatocellular carcinoma (HCC) is the fi fth 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 hampering its extensive use in clinical practice. AIM: 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. MATERIALS AND METHODS: The study comprised of three groups. Group A included 30 patients with CLD diagnosed based on clinical, laboratory, and ultrasonographical investigations; group B included 49 patients with HCC diagnostically confi rmed by spiral CT, elevated alfafetoprotein (AFP), and/or liver biopsy; and group C, the control group, included 15 healthy subjects matched for age and sex. All groups were subjected to thorough history taking, full clinical examination, and laboratory investigations including liver functions, viral markers, and AFP and SCCA estimation using ELISA technique. RESULTS: This study revealed a highly signifi cant difference between patients with HCC, CLD, and controls regarding serum SCCA levels (5.138 ± 7.689, 1.133 ± 0.516, and 0.787 ± 0.432 ng/ml, respectively). SCCA level was persistently elevated in patients with HCC with normal AFP 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 specifi city of 84.4%). The difference between AUC of SCCA and that of AFP was 0.09 which mounted statistical signifi cance. CONCLUSIONS: SCCA could represent a useful tool as a marker for detection of HCC.

Recently introduced biomarkers for screening of hepatocellular carcinoma: a systematic review and meta-analysis

“…1) [7–13]. Two articles described Golgi protein 73 (GP73) as a HCC biomarker [7, 8], two described interleukin-6 (IL-6) [9, 10], and three described squamous cell carcinoma antigen (SCCA) [11–13]. All identified studies provided level 2b evidence on the Oxford Level of Evidence scale and included a control group with ≥10 cirrhotic patients (hepatitis B and/or hepatitis C and/or alcohol abusers), ≥10 patients with a HCC, and ≥10 confirmed healthy persons [5].…”

“…SCCA, a component of the high molecular weight serine protease inhibitors named serpins, is physiologically expressed in the squamous epithelia [11–13]. Increased levels have been detected in several epithelial cancers such as those of the head, neck, cervix, and lung [11–13].…”

“…Increased levels have been detected in several epithelial cancers such as those of the head, neck, cervix, and lung [11–13]. …”

An Overview of Biomarkers for the Diagnosis of Hepatocellular Carcinoma

“…Squamous cell carcinoma antigen (SCCA) which represents a family of serine proteases of high molecular weight, also known as serpins. Hussein et al (54), reported the potential value of SCCA in the diagnosis of HCC. The Sensitivity and specificity for SCCA in HCC diagnosis are 77.6% and 84%, respectively.…”

Hepatocellular Carcinoma: Tumorigenesis and Prediction Markers

“…Alpha-fetoprotein (AFP) is the only biomarker used for HCC diagnosis, however, its use in the early detection of HCC is limited, especially because about one-third parts of patients with HCC have normal levels of serum AFP [66]. Serum AFP is a marker that has low sensitivity and high specificity [8, 24, 67].…”