title: Risk stratification in oral cavity squamous cell carcinoma by preoperative CRP and SCC antigen levels.
abstract: BACKGROUND
  Squamous cell carcinoma antigen (SCC-Ag) level and C-reactive protein (CRP) have been shown to be associated with tumor invasion, lymph node metastasis, staging and survival in patients with oral squamous cell carcinoma (OSCC). The purpose of the present study was to analyze the relationship between preoperative levels of both SCC-Ag and CRP, with clinicopathologic factors and prognosis in OSCC patients.
  
  
  METHODS
  A retrospective study was performed on 142 OSCC patients between March 2008 and March 2011. Their serum SCC-Ag and CRP levels were measured preoperatively.
  
  
  RESULTS
  SCC-Ag level of ≥2.0 ng/ml and CRP level ≥5.0 mg/L were significantly associated with pathologic tumor status (P < 0.001), pathologic nodal metastasis (P = 0.001), tumor depth (≥10 mm vs. <10 mm, P < 0.001), disease-free survival (P ≤ 0.001) and overall survival (P ≤ 0.001). The influence of SCC-Ag and CRP level on disease-free survival (hazard ratio 4.046, 95 % confidence interval 1.698-9.692) and overall survival (hazard ratio 3.655, 95 % confidence interval 1.464-9.130) still existed after adjusting for tumor status, lymph node metastasis and tumor cell differentiation.
  
  
  CONCLUSIONS
  Concurrent high levels of both preoperative SCC-Ag and CRP levels act as a predictor for lymph node metastasis, advanced tumor stage and tumor recurrence. It therefore has significant potential as a biomarker for risk stratification in OSCC.
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taiwan, Republic of China. shiangfu.huang@gmail.com
authors.forename: Shiang-Fu
authors.initials: SF
authors.lastname: Huang
authors.forename: Fu-Chan
authors.initials: FC
authors.lastname: Wei
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Steven
authors.initials: S
authors.lastname: Lo
authors.forename: Jung-Ju
authors.initials: JJ
authors.lastname: Huang
authors.forename: I-How
authors.initials: IH
authors.lastname: Chen
authors.forename: Chung-Jan
authors.initials: CJ
authors.lastname: Kang
authors.forename: Huei-Tzu
authors.initials: HT
authors.lastname: Chien
authors.forename: Hsuan-Ho
authors.initials: HH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000401:mortality* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000097:blood / Q000401:mortality* / Q000601:surgery; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000401:mortality* / Q000601:surgery; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015843:Serpins / Q000097:blood*; D015996:Survival Rate
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015843:Serpins; C051072:squamous cell carcinoma-related antigen; D002097:C-Reactive Protein