SCC antigen (Ag) is a tumor-associated Ag (TAA) obtained from squamous
cell carcinoma of the uterine cervix. This study reports the evaluati
on of this TAA in patients with head and neck malignant diseases and i
ts possible prognostic value. Serum samples from 28 patients with beni
gn head and neck diseases from 399 patients with cancer were obtained
prior to treatment. SCC Ag serum levels were determined by radioimmuno
assay using 2.5 ng/ml as the upper limit of normality. Elevated SCC Ag
serum levels were found in 14% of 28 patients with benign diseases, i
n 29 % of 217 patients with primary tumors, in 48% of 46 patients with
recurrence (43% in locoregional, 64% in metastases) and in 4% of 136
patients with no evidence of disease. In patients with primary tumors,
SCC Ag serum levels were related to nodal involvement and tumor locat
ion with significantly higher levels in node-positive patients (p = 0.
001) and in tumors located in the nasopharynx and piriform sinus (p =
0.02). Presurgical SCC Ag serum levels in patients with primary tumors
had prognostic value with shorter disease-free survival in those pati
ents with abnormal values of this TAA (p < 0.001), in both, node-negat
ive and node-positive patients (p < 0.01). Multivariate analyses showe
d that SCC Ag is a significant independent predictor of disease-free s
urvival even when other prognostic factors are considered. In conclusi
on, pretreatment SCC Ag serum levels are an independent prognostic ind
icator in patients with head and neck malignancies.