SCC Antigen Concentrations in Fine-Needle Aspiration Samples to Detect Cervical Lymph Node Metastases: A Prospective Analysis

Otolaryngol Head Neck Surg. 2023 Mar;168(3):407-412. doi: 10.1177/01945998221102870. Epub 2023 Jan 29.


Objective: To determine the diagnostic value of measuring squamous cell carcinoma antigen (SCC-Ag) and cancer antigen 15-3 (CA15-3) concentrations in fine-needle aspiration (FNA) samples for the detection of squamous cell carcinoma (SCC) metastases in cervical lymph nodes.

Study design: A prospective study with patients consecutively included between November 2018 and May 2021.

Setting: A tertiary head and neck oncologic center.

Methods: Out of 138 patients, SCC-Ag concentrations were analyzed in 168 FNA cervical lymph node samples and CA15-3 in 152 samples. Results were compared with FNA cytology (FNAC) or definitive histology to establish sensitivity and specificity rates.

Results: For the detection of cervical SCC lymph node metastases, SCC-Ag measurement had an 89.4% sensitivity and 79.3% specificity at a cutoff concentration of 0.1 µg/L. Measurement of CA15-3 concentration in addition to SCC-Ag concentration did not lead to improved accuracy for the detection of SCC. In histology-confirmed cases, FNAC had an 80.0% sensitivity and 100% specificity, as opposed to 93.3% and 57.1%, respectively, for SCC-Ag.

Conclusion: Measurement of SCC-Ag concentration for detection of SCC lymph node metastases has a sensitivity at least comparable to FNAC and could be used as a relatively cheap screening tool in samples with nondiagnostic or indeterminate FNAC results or when multiple lymph nodes are sampled. However, SCC-Ag in FNA samples has a lower specificity than FNAC assessed by pathologists experienced in head and neck oncology. Addition of CA15-3 measurement did not lead to improved accuracy.

Keywords: SCC-Ag; fine-needle aspiration; lymph node; mucin 1; squamous cell carcinoma; tumor marker.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy, Fine-Needle / methods
  • Humans
  • Lymph Nodes* / pathology
  • Lymphatic Metastasis / pathology
  • Prospective Studies
  • Sensitivity and Specificity


  • squamous cell carcinoma-related antigen