Early diagnosis and treatment monitoring roles of tumor markers Cyfra 21-1and TPS in oral squamous cell carcinoma

BACKGROUND. Mucosal oral squamous cell carcinoma (SCC) accounts for 3-5% of all reported cancers, with a 5-year survival rate of approximately 50%. Un fortunately, current detection means are of no value in diagnosing lesions early enough for cure, especially when they recur after resection. Postoper ative radiotherapy and/or covering the resection site with reconstructive f laps (regional or free vascularized) often makes early diagnosis an impossi ble task. METHODS, The authors examined the detection and treatment monitoring capaci ty of two relatively new tumor markers in the serum of SCC patients, compar ing their levels with those in patients with other oral/perioral malignanci es or benign oral tumors and with disease free, posttreatment SCC patients and healthy controls. RESULTS. Values of sensitivity, specificity, and positive and negative pred iction for Cyfra 21-1 were 96%, 87%, 93%, and 53%, respectively whereas tho se for tissue polypeptide specific antigen (TPS) were 69%, 87%, 93%, and 54 %, respectively. Approximately 2-3 weeks after resection of the SCC lesion, Cyfra 21-1 and TPS levels were reduced by 47% (P less than or equal to 0.0 03) and 36% (P less than or equal to 0.041), respectively. Cyfra 21-1 level s in SCC patients were significantly greater than those of healthy patients by 73% (P less than or equal to 0.0001), patients with benign tumors by 74 % (P less than or equal to 0.0003), and patients in disease remission by 66 % (P less than or equal to 0.0002). Similarly, the TPS levels of SCC patien ts were significantly greater than those of healthy patients by 59% (P less than or equal to 0.0005), patients with benign tumors by 55% (P less than or equal to 0.0001), and patients in disease remission by 59% (P less than or equal to 0.0001). In two patients, a second, new SCC lesion was diagnose d within the follow-up period. with increased tumor markers noted concomita ntly with the diagnosis. CONCLUSIONS. The accumulated data point to the suitability of the clinical usage of these two markers, especially Cyfra 21-1, in the early detection o f oral SCC lesions (primary, recurrent, or secondary) as well as for treatm ent monitoring. These results may open new avenues for the diagnosis and fo llow-up of these patients and hopefully improve their treatment outcome. Ca ncer 1999;85:1018-25. (C) 1999 American Cancer Society.