Diagnostic accuracy of serum squamous cell carcinoma antigen and squamous cell carcinoma antigen‑immunoglobulin M for hepatocellular carcinoma: A meta‑analysis

Zhang,Jian; Shao,Chuxiao; Zhou,Qingyun; Zhu,Yimin; Zhu,Jinde; Tu,Chaoyong

doi:10.3892/mco.2015.600

Diagnostic accuracy of serum squamous cell carcinoma antigen and squamous cell carcinoma antigen‑immunoglobulin M for hepatocellular carcinoma: A meta‑analysis

Authors:
- Jian Zhang
- Chuxiao Shao
- Qingyun Zhou
- Yimin Zhu
- Jinde Zhu
- Chaoyong Tu
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Affiliations: Department of Hepatobiliary and Pancreatic Surgery, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang 323000, P.R. China, Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, Zhejiang 310058, P.R. China
Published online on: July 8, 2015 https://doi.org/10.3892/mco.2015.600
Pages: 1165-1171

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Abstract

A number of individual studies have evaluated the diagnostic efficiency of serum squamous cell carcinoma antigen (SCCA) and SCCA‑immunoglobulin (IgM) for diagnosing hepatocellular carcinoma (HCC), but the results have been conflicting. The aim of this study was to determine the diagnostic accuracy of serum SCCA and SCCA‑IgM for HCC. A systematic review of related studies was conducted and relevant data on the accuracy of serum SCCA and SCCA‑IgM in the diagnosis of HCC were pooled using random‑effects models. Summary receiver operating characteristic curve (SROC) analysis was used to summarize the overall test performance. A total of 12 studies were included in our meta‑analysis. The summary estimates for serum SCCA and SCCA‑IgM for HCC diagnosis in the included studies were as follows: Sensitivity = 0.59 (95% CI: 0.56‑0.62) vs. 0.60 (95% CI: 0.56‑0.63); specificity = 0.76 (95% CI: 0.73‑0.79) vs. 0.70 (95% CI: 0.67‑0.73); diagnostic odds ratio (DOR) = 6.68 (95% CI: 3.71‑12.03) vs. 7.32 (95% CI: 3.31‑16.15); and area under the SROC curve = 0.7826 vs. 0.7955. Therefore, SCCA and SCCA‑IgM exhibited moderate diagnostic accuracy for HCC. Due to the design limitations, the results of published studies should be interpreted with caution. In addition, well‑designed studies including larger sample sizes should be conducted to rigorously evaluate the diagnostic value of SCCA and SCCA‑IgM.

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1	Forner A, Llovet JM and Bruix J: Hepatocellular carcinoma. Lancet. 379:1245–1255. 2012. View Article : Google Scholar : PubMed/NCBI
2	Pirastu R, Biggeri A and Comba P: International Agency for Research on Cancer Monographs (IARC). G Ital Med Lav Ergon. 30:83–84; author reply 86–87. 2008.(In Italian). PubMed/NCBI
3	Pontisso P, Calabrese F, Benvegnù L, et al: Overexpression of squamous cell carcinoma antigen variants in hepatocellular carcinoma. Br J Cancer. 90:833–837. 2004. View Article : Google Scholar : PubMed/NCBI
4	Catanzaro JM, Guerriero JL, Liu J, et al: Elevated expression of squamous cell carcinoma antigen (SCCA) is associated with human breast carcinoma. PLoS One. 6:e190962011. View Article : Google Scholar : PubMed/NCBI
5	Kim YT, Yoon BS, Kim JW, et al: Pretreatment levels of serum squamous cell carcinoma antigen and urine polyamines in women with squamous cell carcinoma of the cervix. Int J Gynaecol Obstet. 91:47–52. 2005. View Article : Google Scholar : PubMed/NCBI
6	Stenman J, Hedström J, Grénman R, et al: Relative levels of SCCA2 and SCCA1 mRNA in primary tumors predicts recurrent disease in squamous cell cancer of the head and neck. Int J Cancer. 95:39–43. 2001. View Article : Google Scholar : PubMed/NCBI
7	Giannelli G, Fransvea E, Trerotoli P, et al: Clinical validation of combined serological biomarkers for improved hepatocellular carcinoma diagnosis in 961 patients. Clin Chim Acta. 383:147–152. 2007. View Article : Google Scholar : PubMed/NCBI
8	Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MM, Sterne JA and Bossuyt PM: QUADAS-2 Group: QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 155:529–536. 2011. View Article : Google Scholar : PubMed/NCBI
9	Devillé WL, Buntinx F, Bouter LM, et al: Conducting systematic reviews of diagnostic studies: Didactic guidelines. BMC Med Res Methodol. 2:92002. View Article : Google Scholar : PubMed/NCBI
10	Zamora J, Abraira V, Muriel A, Khan K and Coomarasamy A: Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol. 6:312006. View Article : Google Scholar : PubMed/NCBI
11	Walter SD: Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Stat Med. 21:1237–1256. 2002. View Article : Google Scholar : PubMed/NCBI
12	Higgins JP, Thompson SG, Deeks JJ and Altman DG: Measuring inconsistency in meta-analyses. BMJ. 327:557–560. 2003. View Article : Google Scholar : PubMed/NCBI
13	Pozzan C, Cardin R, Piciocchi M, et al: Diagnostic and prognostic role of SCCA-IgM serum levels in hepatocellular carcinoma (HCC). J Gastroenterol Hepatol. 29:1637–1644. 2014. View Article : Google Scholar : PubMed/NCBI
14	Soyemi OM, Otegbayo JA, Ola SO, Akere A and Soyemi T: Comparative diagnostic efficacy of serum squamous cell carcinoma antigen in hepatocellular carcinoma. BMC Res Notes. 5:4032012. View Article : Google Scholar : PubMed/NCBI
15	Trerotoli P, Fransvea E, Angelotti U, et al: Tissue expression of squamous cellular carcinoma antigen (SCCA) is inversely correlated to tumor size in HCC. Mol Cancer. 8:292009. View Article : Google Scholar : PubMed/NCBI
16	Hussein MM, Ibrahim AA, Abdella HM, Montasser IF and Hassan MI: Evaluation of serum squamous cell carcinoma antigen as a novel biomarker for diagnosis of hepatocellular carcinoma in Egyptian patients. Indian J Cancer. 45:167–172. 2008. View Article : Google Scholar : PubMed/NCBI
17	Giannelli G, Marinosci F, Trerotoli P, et al: SCCA antigen combined with alpha-fetoprotein as serologic markers of HCC. Int J Cancer. 117:506–509. 2005. View Article : Google Scholar : PubMed/NCBI
18	Beneduce L, Castaldi F, Marino M, et al: Squamous cell carcinoma antigen-immunoglobulin M complexes as novel biomarkers for hepatocellular carcinoma. Cancer. 103:2558–2565. 2005. View Article : Google Scholar : PubMed/NCBI
19	Salman T, Raouf AA, Saleh SM, Salama M and Mohammed AAE: Comparative study between serum alpha-fetoprotein, VEGF and SCCA in enhancing detection of hepatocellular carcinoma in Egyptian patients. Hepatol Int. 5:392011.
20	Wu X: Clinical application value of serum squamous cell carcinoma antigen in hepatocellular carcinoma. Wenzhou Medical University. 2007.(In Chinese).
21	Zhai L, Li J, Yang X, et al: Combine serum AFP, GP73 and SCCA IgM IC to detect early hepatocellular carcinoma of HBV related. Shandong Medical Journal. 34–37. 2014.(In Chinese).
22	Chen X, Sun P and Yao X: Squamous cell carcinoma antigen detection in the diagnosis of primary liver cancer. Chin J Pract Med. 37:69–70. 2010.(In Chinese).
23	Zhai Q: Tumor markers in the diagnosis of hepatocellular carcinoma. Chin J Prim Med Pharm. 1614–1615. 2009.(In Chinese).
24	Zhu J, Jiang F, Ni HB, et al: Combined analysis of serum γ-glutamyl transferase isoenzyme II, α-L-fucosidase and α-fetoprotein detected using a commercial kit in the diagnosis of hepatocellular carcinoma. Exp Ther Med. 5:89–94. 2013.PubMed/NCBI
25	Witjes CD, van Aalten SM, Steyerberg EW, et al: Recently introduced biomarkers for screening of hepatocellular carcinoma: A systematic review and meta-analysis. Hepatol Int. 7:59–64. 2013. View Article : Google Scholar : PubMed/NCBI
26	Choi JY, Jung SW, Kim HY, et al: Diagnostic value of AFP-L3 and PIVKA-II in hepatocellular carcinoma according to total-AFP. World J Gastroenterol. 19:339–346. 2013. View Article : Google Scholar : PubMed/NCBI
27	Zhou Y, Yin X, Ying J and Zhang B: Golgi protein 73 versus alpha-fetoprotein as a biomarker for hepatocellular carcinoma: A diagnostic meta-analysis. BMC Cancer. 12:172012. View Article : Google Scholar : PubMed/NCBI
28	Marrero JA and El-Serag HB: Alpha-fetoprotein should be included in the hepatocellular carcinoma surveillance guidelines of the American Association for the Study of Liver Diseases. Hepatology. 53:1060–1061; author reply 1061–1062. 2011. View Article : Google Scholar : PubMed/NCBI
29	Hu JS, Wu DW, Liang S and Miao XY: GP73, a resident Golgi glycoprotein, is sensibility and specificity for hepatocellular carcinoma of diagnosis in a hepatitis B-endemic Asian population. Med Oncol. 27:339–345. 2010. View Article : Google Scholar : PubMed/NCBI
30	Akutsu N, Yamamoto H, Sasaki S, et al: Association of glypican-3 expression with growth signaling molecules in hepatocellular carcinoma. World J Gastroenterol. 16:3521–3528. 2010. View Article : Google Scholar : PubMed/NCBI
31	Shirakawa H, Kuronuma T, Nishimura Y, et al: Glypican-3 is a useful diagnostic marker for a component of hepatocellular carcinoma in human liver cancer. Int J Oncol. 34:649–656. 2009.PubMed/NCBI
32	Zoli M, Magalotti D, Bianchi G, et al: Efficacy of a surveillance program for early detection of hepatocellular carcinoma. Cancer. 78:977–985. 1996. View Article : Google Scholar : PubMed/NCBI
33	Trevisani F, Dintino PE, Morselli-Labate AM, et al: Serum alpha-fetoprotein for diagnosis of hepatocellular carcinoma in patients with chronic liver disease: Influence of HBsAg and anti-HCV status. J Hepatol. 34:570–575. 2001. View Article : Google Scholar : PubMed/NCBI
34	Gambarin-Gelwan M, Wolf DC, Shapiro R, Schwartz ME and Min AD: Sensitivity of commonly available screening tests in detecting hepatocellular carcinoma in cirrhotic patients undergoing liver transplantation. Am J Gastroenterol. 95:1535–1538. 2000. View Article : Google Scholar : PubMed/NCBI
35	Bruix J and Sherman M: American Association for the Study of Liver Diseases: Management of hepatocellular carcinoma: An update. Hepatology. 53:1020–1022. 2011. View Article : Google Scholar : PubMed/NCBI
36	Glas AS, Lijmer JG, Prins MH, Bonsel GJ and Bossuyt PM: The diagnostic odds ratio: A single indicator of test performance. J Clin Epidemiol. 56:1129–1135. 2003. View Article : Google Scholar : PubMed/NCBI