Diagnostic Efficacy of Serum Squamous Cell Carcinoma Antigen for Cancerous and Noncancerous Diseases: A Single-Center Experience in China

Abstract

Background: Although squamous cell carcinoma antigen (SCCA) is a tumor biomarker used in the diagnosis of cancer, it is also elevated in non-oncological diseases. However, the diagnostic efficiency of SCCA for different diseases has yet to be systematically investigated. The purpose of this study was to explore the diagnostic efficacy of serum SCCA in neoplastic and non-neoplastic diseases. Methods: The clinical, pathological, and serological data for 15,844 patients admitted to Hainan Hospital of PLA General Hospital between November 2018 and May 2022 were collected and retrospectively analyzed. Results: Patients diagnosed with cervical cancer, bladder cancer, esophageal cancer, lung cancer, psoriasis, uremia, chronic renal failure, and nephritis had a mean serum SCCA value which exceeded the upper limit of the reference range (2.0 ng/mL). Squamous cell carcinoma (SCC) had considerably higher serum SCCA levels than other pathological types. The severity of renal failure is positively associated with a gradual increase in serum SCCA levels. Multivariate logistic analysis showed that SCCA was an indicator of uremia [odds ratio (OR), 1.845; 95% confidence interval (CI): 1.040–2.100; p = 0.038]. Receiver operating characteristic (ROC) curves demonstrated that the sensitivity (Sen) of SCCA in the diagnosis of uremia and psoriasis was 89.80% and 86.73%, respectively, and the specificity (Spe) was 75.00% and 78.79%, respectively. The area under the ROC curve (AUC) (95% CI) was 0.920 (0.882–0.958) and 0.907 (0.841–0.974), respectively, which was higher than cervical SCC [Sen: 81.63%; Spe: 68.46%, AUC (95% CI): 0.751 (0.609–0.793)]. Calculations of positive and negative likelihood ratios also supported these findings. Conclusions: While SCCA is a specific marker for SCC, its diagnostic accuracy is higher for noncancerous diseases such as uremia, psoriasis, and renal failure, indicating the need for clinicians to consider the correlation between SCCA and certain noncancerous diseases while evaluating tumor development and monitoring therapeutic efficacy.