title: Squamous cell carcinoma antigen as a diagnostic marker of nasal inverted papilloma.
abstract: BACKGROUND
  Serum squamous cell carcinoma antigen (SCCA) levels are elevated in sinonasal inverted papilloma (IP). However, the relationship between tumor volume and SCCA level, and the influence of skin or pulmonary diseases in which the SCCA level is high, have not been established.
  
  
  OBJECTIVE
  To clarify whether the level of serum SCCA can be used as a diagnostic marker of IP.
  
  
  METHODS
  Serum SCCA level was measured in 30 patients with IP (IP group) and 57 with inflammatory disease (inflammatory group).
  
  
  RESULTS
  Overall, 83.3% in the IP group showed elevated serum SCCA levels regardless of whether they were new patients or patients with recurrent IP, and SCCA levels rapidly decreased after surgery. Only 5.3% had elevated SCCA levels in the inflammatory group. Before surgery, the IP group had a median preoperative SCCA level of 2.4 ng/mL, whereas the median preoperative SCCA level was 0.9 ng/mL in the inflammatory group. Pre- and postoperative SCCA levels were significantly different in the IP group. With regard to the IP diagnosis in the IP and inflammatory groups based on the SCCA level (≤1.5 ng/mL), sensitivity and specificity were 83.3% and 94.7%, respectively. There was no significant correlation between SCCA elevation and respiratory function, and skin disease in the two groups, except for smoking in the IP group. Preoperative SCCA levels were significantly higher in smokers than in never-smokers in the IP group. Tumor volume was significantly correlated with SCCA level in IP. Multivariable logistic analysis showed that tumor volume was a predictor of preoperative SCCA elevation (p = 0.036; 95% confidence interval, 1.027-2.176).
  
  
  CONCLUSIONS
  Serum SCCA level is a reliable diagnostic marker to distinguish new and recurrent IP from inflammatory disease. Because smokers tended to have higher SCCA levels in IP, a different cutoff level might be needed. Although respiratory dysfunction and skin disease were not related to SCCA level, they should be taken into consideration when evaluating SCCA level.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
authors.forename: Yukashi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Takayuki
authors.initials: T
authors.lastname: Uehara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Zeyi
authors.initials: Z
authors.lastname: Deng
authors.forename: Sen
authors.initials: S
authors.lastname: Matayoshi
authors.forename: Asanori
authors.initials: A
authors.lastname: Kiyuna
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kondo
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maeda
authors.forename: Akira
authors.initials: A
authors.lastname: Ganaha
authors.forename: Mikio
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018308:Papilloma, Inverted / Q000175:diagnosis* / Q000473:pathology; D015843:Serpins / Q000378:metabolism*; D012852:Sinusitis / Q000175:diagnosis* / Q000473:pathology; D012907:Smoking / Q000009:adverse effects; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015843:Serpins; C051072:squamous cell carcinoma-related antigen