[Diagnosis of recurrences of head and neck carcinoma with the tumor marker SSC-antigen]. / Diagnostik von Kopf-Hals-Karzinom-Rezidiven mit dem Tumormarker SSC-Antigen.

ABSTRACT

BACKGROUND: The follow-up of squamous cell carcinomas of the head and neck is often challenging. Due to tissue alteration and anatomic changes after primary treatment or submucosal tumor growth, recurrences are sometimes detected very late. The tumor marker SCC-Antigen (SCC-Ag) may provide additional information for early detection of such tumor recurrences. PATIENTS Serum levels of SCC-Ag in 578 patients with primary squamous cell carcinomas of the head and neck were assayed by SCC-RIA and IMx-SCC before treatment and every 2-3 months during follow-up. During the observation period of 30-84 (mean 50) months, 179 recurrences were verified by histologic examination. RESULTS: Seventy-seven patients (43%) with tumor recurrence showed elevated serum levels of SCC-Ag (< 2.0 ng/ml). Fifty-eight (32%) of them exhibited elevated levels of SCC-Ag up to 11 months (mean 6.1 months) prior to histopathologic diagnosis. This mainly became evident in 48 (83%) patients whose SCC-Ag serum levels were elevated before treatment. CONCLUSION: Use of SCC-Antigen in head and neck tumors follow-up can provide early evidence of almost one third of all recurrences of squamous cell carcinomas of the head and neck. For clinical purposes, we recommend an initial analysis of the SCC-Ag serum level in every patient with primary squamous cell carcinoma of the head and neck. The SCC levels of all SCC positive patients should be closely monitored. Elevated SCC should be regarded as a potential early sign for recurrence and therefore indicates the need for intensified follow-up. Depending on the individual situation this should include ultrasonography, CT, MRI and especially frequent endoscopy in general anesthesia with multiple biopsies of suspicious regions.