Medknow Publications on behalf of Indian Cancer Society
Abstract
Background: 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 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 confirmed 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 significant difference between patients with HCC,
CLD, and controls regarding serum SCCA levels (5.138 \ub1 7.689,
1.133 \ub1 0.516, and 0.787 \ub1 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 specificity of 84.4%). The
difference between AUC of SCCA and that of AFP was 0.09 which mounted
statistical significance. Conclusions: SCCA could represent a useful
tool as a marker for detection of HCC