SQUAMOUS CELL CARCINOMA ANTIGEN AS DIAGNOSTIC FOR HEPATOCELLULAR CARCINOMA MARKER

Background: Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer, and the second leading cause of cancer-related deaths. Contributing to the poor prognosis of HCC is the lack of specific symptoms in the early stages of the disease. More than 60% of patients are diagnosed with late-stage disease after metastasis has occurred. Many recent literatures have reported that the squamous cell carcinoma antigen (SCCA) is over expressed in HCC tissues with a higher concentration of this antigen in the serum of HCC patients than cirrhotic patients.

Aim: So this work aims to investigate whether SCCA serum levels are considered as a useful tool for HCC diagnosis or not.

Patients and Methods: The present study was done on a total number 141 included 47 healthy individuals as control group. Blood samples were obtained from 94 patients with chronic liver disease, divided into two groups: Group (I) included 47 patients with HCC; Patients with cancers other than HCC or metastatic liver cancer were excluded. Group (II) included 47 patients with liver cirrhosis and without any evidence of HCC. Questionnaire was used to collect clinical data while Alpha-fetoprotein (AFP), SCCA levels, serum HBsAg and anti-HCV were determined using ELISA method. Abdominal ultrasound scan and computed CT were also done for all participants.

Results: The mean AFP value for cases with HCC was higher than those in patients with cirrhotic p and control healthy adults. The mean SCCA level was 2.54±0.56 ng/ml in control while for HCC and cirrhosis cases were 6.42±3.18 and 3.62±1.2 ng/ml respectively (P = 0.001). The receiver operating curve (ROC) was done for AFP and SCCA, the area under curve (AUC) for AFP was 0.865, the sensitivity was 74.47% and a specificity of 100%. For SCCA, the area under curve (AUC) was 0.904; the sensitivity was 82.98% and a specificity of 95.56%.

Conclusion: The ROC for the SCCA indicated that, it is considered superior on AFP in detection of hepatocellular carcinoma. This reflects its accuracy as a good screening test for hepatocellular carcinoma compared AFP.