Squamous cell carcinoma antigen as a prognostic marker and its correlation with clinicopathological features in head and neck squamous cell carcinoma: Systematic review and meta-analysis

J Oral Pathol Med. 2018 Jan;47(1):3-10. doi: 10.1111/jop.12600. Epub 2017 Jul 5.

Abstract

Background: Several studies investigate the prognostic value of squamous cell carcinoma antigen (SCC-Ag) in head and neck squamous cell carcinoma (HNSCC) patients, with contradicting findings. Considering this, the aim of this study was to evaluate the prognostic value of high SCC-Ag levels and its association with clinicopathological features of HNSCC.

Material and methods: PubMed, SCOPUS, and Cochrane Library were searched for relevant studies up to December 2015. English-language publications assessing clinicopathological features of HNSCC and the prognostic significance of SCC-Ag in this disease were included. A meta-analysis was performed using Review Manager 5.3 and STATA version 14 software to clarify a possible association between SCC-Ag and clinical outcomes.

Results: A total of 11 studies met inclusion criteria, comprising 1901 cases of HNSCC. The results of the meta-analysis showed that there was significant correlation between high SCC-Ag levels and males (odds ratio [OR]=2.99, 95% CI: 1.18-7.57, P=.02 fixed-effect), and advanced TNM stages (OR=3.18, 95% CI: 1.88-5.38, P<.0001 random-effect). The survival meta-analysis showed a pooled hazard ratio for disease-free survival (DFS) and overall survival (OS) of 1.01 (95% CI: 0.70-1.31) and 0.86 (95% CI: 0.54-1.17), respectively.

Conclusion: Our meta-analysis suggests that elevated SCC-Ag levels have a significant correlation with males and TNM stage, but may not be used as predictive marker for OS and DFS in HNSCC patients.

Keywords: head and neck squamous cell carcinoma; meta-analysis; prognosis; squamous cell carcinoma antigen; tumor markers.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antigens, Neoplasm* / blood
  • Biomarkers, Tumor* / blood
  • Carcinoma, Squamous Cell* / blood
  • Carcinoma, Squamous Cell* / diagnosis
  • Carcinoma, Squamous Cell* / pathology
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms* / blood
  • Head and Neck Neoplasms* / diagnosis
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Male
  • Prognosis
  • Proportional Hazards Models
  • Serpins* / blood
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis

Substances

  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Serpins
  • squamous cell carcinoma-related antigen