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Test Code SCCA Squamous Cell Carcinoma Antigen, Serum


Specimen Required


Collection Container/Tube: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Information: Centrifuge and aliquot serum into a plastic vial. Do not submit in original tube.


Useful For

Aiding in the evaluation and monitoring of squamous cell carcinoma of the head and neck, lung, and cervix

 

This test should not be used to screen for carcinoma or other disorders including those of the liver, lung, or skin.

Method Name

Immunofluorescent Assay (IFA)

Reporting Name

Squamous Cell Carcinoma Antigen, S

Specimen Type

Serum SST

Specimen Minimum Volume

0.2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum SST Frozen (preferred) 90 days
  Ambient  7 days
  Refrigerated  7 days

Reference Values

Males: ≤2.00 mcg/L

Females: ≤1.67 mcg/L

 

Reference values have not been established for patients younger than 18 years old.

Interpretation

Squamous cell carcinoma antigen (SCCA) concentrations alone should not be interpreted as evidence of the presence or absence of malignancy. Although the sensitivity of this assay for the presence of squamous cell carcinoma (SCC) is not ideal, SCCA remains one of the few clinically viable potential circulating markers used for the detection and monitoring of SCC. Previous estimates of sensitivity are 20% to 53% for lung SCC(1,2) and 38% for tonsil and tongue SCC.(3) In a previous study, SCCA was elevated (>2 ng/ml) in 21.6% of untreated cervical squamous cell carcinomas.(4) Serum levels of SCCA in cervical cancer were significantly related to tumor stage, size, and depth of infiltration(5) and may also serve as a prognostic predictor of overall outcome.(6)

 

SCCA is expressed in normal epithelial tissues and may be elevated in nonmalignant conditions such as tuberculosis, sarcoidosis, eczema, erythroderma, and psoriasis. Psoriasis, in particular, is known to exhibit elevated SCCA concentrations. Additionally, serum concentrations of squamous cell carcinoma antigen have been reported to be elevated in severe cases of atopic dermatitis and asthma. Although there are conflicting reports, SCCA has been shown to be elevated in hepatocellular carcinoma (HCC) and may serve as a potential marker of HCC. A study of 961 patients (HCC, n =499)(7) indicated that at a serum SCCA cut-off of 3.8 ng/mL, sensitivity was 42% with a specificity of 83% for patients with HCC.

 

This Brahms Kryptor total SCCA assay detects both SCCA1 and SCCA2 antigen isoforms with a 90% and 72% measured recovery, respectively.

Clinical Reference

1. Fischbach W, Rink C: SCC-Antigen: ein sensitiver und spezifischer Tumormarker fur Plattenepithelkarzinome? [SCC antigen: a sensitive and specific tumor marker for squamous cell carcinoma?]. Dtsch Med Wochenschr. 1988 Feb 26;113(8):289-293. doi: 10.1055/s-2008-1067632

2. Tas F, Aydiner A, Topuz E, Yasasever V, Karadeniz A, Saip P: Utility of the serum tumor markers: CYFRA 21.1, carcinoembryonic antigen (CEA), and squamous cell carcinoma antigen (SCC) in squamous cell lung cancer. J Exp Clin Cancer Res. 2000 Dec;19(4):477-481

3. Fischbach W, Meyer T, Barthel K: Squamous cell carcinoma antigen in the diagnosis and treatment follow-up of oral and facial squamous cell carcinoma. Cancer. 1990 Mar 15;65(6):1321-1324

4. Bolger BS, Dabbas M, Lopes A, Monaghan JM: Prognostic value of preoperative squamous cell carcinoma antigen level in patients surgically treated for cervical carcinoma. Gynecol Oncol. 1997 May;65(2):309-313

5. Gaarenstroom KN, Kenter GG, Bonfrer JM, et al: Can initial serum cyfra 21-1, SCC antigen, and TPA levels in squamous cell cervical cancer predict lymph node metastases or prognosis? Gynecol Oncol. 2000 Apr;77(1):164-170. doi: 10.1006/gyno.2000.5732

6. Liu Z, Shi H: Prognostic role of squamous cell carcinoma antigen in cervical cancer: A meta-analysis. Dis Markers. 2019 Jun 2;2019:6710352. doi: 10.1155/2019/6710352

7. Giannelli G, Marinosci F, Sgarra C, Lupo L, Dentico P, Antonaci S: Clinical role of tissue and serum levels of SCCA antigen in hepatocellular carcinoma. Int J Cancer. 2005 Sep 10;116(4):579-583. doi: 10.1002/ijc.20847

8. Bae SN, Namkoong SE, Jung JK, et al: Prognostic significance of pretreatment squamous cell carcinoma antigen and carcinoembryonic antigen in squamous cell carcinoma of the uterine cervix. Gynecol Oncol. 1997 Mar;64(3):418-424

9. Beale G, Chattopadhyay D, Gray J, et al: AFP, PIVKAII, GP3, SCCA-1 and follisatin as surveillance biomarkers for hepatocellular cancer in non-alcoholic and alcoholic fatty liver disease. BMC Cancer. 2008 Jul;8:200. doi: 10.1186/1471-2407-8-200

10. Duk JM, van Voorst Vader PC, ten Hoor KA, Hollema H, Doeglas HM, de Bruijn HW: Elevated levels of squamous cell carcinoma antigen in patients with a benign disease of the skin. Cancer. 1989 Oct 15;64(8):1652-1656. doi: 10.1002/1097-0142(19891015)64:8<1652::aid-cncr2820640816>3.0.co;2-m

11. Watanabe Y, Yamaguchi Y, Komitsu N, et al: Elevation of serum squamous cell carcinoma antigen 2 in patients with psoriasis: associations with disease severity and response to the treatment. Br J Dermatol. 2016 Jun;174(6):1327-1336. doi: 10.1111/bjd.14426

12. Mitsuishi K, Nakamura T, Sakata Y, et al: The squamous cell carcinoma antigens as relevant biomarkers of atopic dermatitis. Clin Exp Allergy. 2005 Oct;35(10):1327-33. doi: 10.1111/j.1365-2222.2005.02353.x

13. Ohta S, Shibata R, Nakao Y, et al: The usefulness of combined measurements of squamous cell carcinoma antigens 1 and 2 in diagnosing atopic dermatitis. Ann Clin Biochem. 2012 May;49(Pt 3):277-284. doi: 10.1258/acb.2011.011065

14. Liu Y, Cao Y, He S, Cai W. Technical and clinical performance of two methods to detect squamous cell carcinoma antigen levels for comparing pathological diagnosis coincidence rates in lung, cervical, and head and neck cancers. Clin Lab. 2020 Jul 1;66(7). doi: 10.7754/Clin.Lab.2019.190912

15. Zhou Z, Li W, Zhang F, Hu K: The value of squamous cell carcinoma antigen (SCCa) to determine the lymph nodal metastasis in cervical cancer: A meta-analysis and literature review. PLoS One. 2017 Dec 11;12(12):e0186165

16. Zheng NN, Zhang RC, Yang XX, Tao YK, Zhong LS: Squamous cell carcinoma antigen is useful in the differential diagnosis of erythroderma. Int J Derm. 2019 Aug;58(8):e158-e159. doi: 10.1111/ijd.14498

Day(s) Performed

Tuesday

Report Available

Same day/1 day to 7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

86316

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SCCA Squamous Cell Carcinoma Antigen, S 9679-2

 

Result ID Test Result Name Result LOINC Value
SCCA Squamous Cell Carcinoma Antigen, S 9679-2