Diagnostic and prognostic significance of squamous cell carcinoma antigen in non-small cell lung cancer

Lung Cancer. 2001 May;32(2):137-44. doi: 10.1016/s0169-5002(00)00225-7.


Squamous cell carcinoma antigen (SCC-Ag) is a glycoprotein secreted by non-small cell lung tumours (NSCLC). This study investigated the diagnostic and prognostic significance of SCC-Ag in NSCLC. Receiver operating characteristic (ROC) curve analysis was used to test the diagnostic performance of the SCC-Ag and determine the optimal threshold value in a group of 100 NSCLC patients undergoing surgery and 50 age matched healthy controls. This threshold was then prospectively validated in a group of 53 patients and 49 healthy controls. The prognostic significance of the preoperative SCC-Ag level and its postoperative decrease were tested using univariate and multivariate proportional hazard models. The area under the ROC curve was 0.71+/-0.04, and the best cutoff value was 1.4 ng/ml. This discriminated patients in the validation group, with a sensitivity of 0.55 and a specificity of 1.0. The hazard ratio was 0.144 (95% CI 0.074-0.281) for the postoperative decrease in the SCC Ag, and 5.823 (3.299-10.278) for the preoperative SCC Ag level. Multivariate analysis revealed that only disease stage and patients' age are strong prognostic factors for survival. In conclusion, the SCC-Ag serum level has moderate diagnostic role in NSCLC. Both the preoperative SCC-Ag level and its postoperative decrease have prognostic significance, yet inferior to the disease stage and the patient's age.

Publication types

  • Validation Study

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery
  • Aged
  • Antigens, Neoplasm / blood*
  • Biomarkers, Tumor / blood*
  • Carcinoma, Large Cell / blood
  • Carcinoma, Large Cell / diagnosis
  • Carcinoma, Large Cell / mortality
  • Carcinoma, Large Cell / surgery
  • Carcinoma, Non-Small-Cell Lung / blood*
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Female
  • Humans
  • Life Tables
  • Lung Neoplasms / blood*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / mortality
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Serpins*
  • Survival Analysis


  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Serpins
  • squamous cell carcinoma-related antigen