Diagnostic and prognostic significance of squamous cell carcinoma antigen in non-small cell lung cancer.
Squamous cell carcinoma antigen (SCC-Ag) is a glycoprotein secreted by non-small cell lung tumours (NSCLC). This study investigated the diagnostic and prognostic significance of SCC-Ag in NSCLC. Receiver operating characteristic (ROC) curve analysis was used to test the diagnostic performance of the SCC-Ag and determine the optimal threshold value in a group of 100 NSCLC patients undergoing surgery and 50 age matched healthy controls. This threshold was then prospectively validated in a group of 53 patients and 49 healthy controls. The prognostic significance of the preoperative SCC-Ag level and its postoperative decrease were tested using univariate and multivariate proportional hazard models. The area under the ROC curve was 0.71+/-0.04, and the best cutoff value was 1.4 ng/ml. This discriminated patients in the validation group, with a sensitivity of 0.55 and a specificity of 1.0. The hazard ratio was 0.144 (95% CI 0.074-0.281) for the postoperative decrease in the SCC Ag, and 5.823 (3.299-10.278) for the preoperative SCC Ag level. Multivariate analysis revealed that only disease stage and patients' age are strong prognostic factors for survival. In conclusion, the SCC-Ag serum level has moderate diagnostic role in NSCLC. Both the preoperative SCC-Ag level and its postoperative decrease have prognostic significance, yet inferior to the disease stage and the patient's age.
Vassilakopoulos
T
T
Department of Critical Care and Pulmonary Services, Evangelismos Hospital, University of Athens Medical School, Athens, Greece.
Troupis
T
T
Sotiropoulou
C
C
Zacharatos
P
P
Katsaounou
P
P
Parthenis
D
D
Noussia
O
O
Troupis
G
G
Papiris
S
S
Kittas
C
C
Roussos
C
C
Zakynthinos
S
S
Gorgoulis
V
V
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D018287:Carcinoma, Large Cell / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D015993:Life Tables; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D015843:Serpins; D016019:Survival Analysis
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015843:Serpins; C051072:squamous cell carcinoma-related antigen