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Risk Stratification in Oral Cavity Squamous Cell Carcinoma by Preoperative CRP and SCC Antigen Levels

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Squamous cell carcinoma antigen (SCC-Ag) level and C-reactive protein (CRP) have been shown to be associated with tumor invasion, lymph node metastasis, staging and survival in patients with oral squamous cell carcinoma (OSCC). The purpose of the present study was to analyze the relationship between preoperative levels of both SCC-Ag and CRP, with clinicopathologic factors and prognosis in OSCC patients.

Methods

A retrospective study was performed on 142 OSCC patients between March 2008 and March 2011. Their serum SCC-Ag and CRP levels were measured preoperatively.

Results

SCC-Ag level of ≥2.0 ng/ml and CRP level ≥5.0 mg/L were significantly associated with pathologic tumor status (P < 0.001), pathologic nodal metastasis (P = 0.001), tumor depth (≥10 mm vs. <10 mm, P < 0.001), disease-free survival (P ≤ 0.001) and overall survival (P ≤ 0.001). The influence of SCC-Ag and CRP level on disease-free survival (hazard ratio 4.046, 95 % confidence interval 1.698–9.692) and overall survival (hazard ratio 3.655, 95 % confidence interval 1.464–9.130) still existed after adjusting for tumor status, lymph node metastasis and tumor cell differentiation.

Conclusions

Concurrent high levels of both preoperative SCC-Ag and CRP levels act as a predictor for lymph node metastasis, advanced tumor stage and tumor recurrence. It therefore has significant potential as a biomarker for risk stratification in OSCC.

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Acknowledgment

This study was supported by grants CMRPG340381, CMRPG360701, CMRPG360851, CMRPG371511, and CMRPG3A0281 from the Chang Gung Memorial Hospital, NSC99-2314-B-182A-036-MY3 from the National Science Council, and DOH99-TD-C-111-006 from Department of Health, Department Executive Yuan, Taiwan.

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Authors and Affiliations

  1. Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taiwan, Republic of China

    Shiang-Fu Huang MD, PhD, Chun-Ta Liao MD, I-How Chen MD, Chung-Jan Kang MD & Hsuan-Ho Chen MD

  2. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University, Taiwan, Republic of China

    Fu-Chan Wei MD, Steven Lo MD & Jung-Ju Huang MD

  3. Department of Medical Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China

    Hung-Ming Wang MD

  4. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China

    Chien-Yu Lin MD

  5. Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China

    Huei-Tzu Chien MS

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  1. Shiang-Fu Huang MD, PhD
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Correspondence to Shiang-Fu Huang MD, PhD.

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10434_2012_2392_MOESM1_ESM.jpg

Figure S1. Survival curves in 142 OSCC patients related to the preoperative CRP level. a The lower CRP group (<5.0 mg/L) showed significantly better DFS compared to the higher CRP level group (≥5.0 mg/L) (P < 0.001). b The lower CRP group showed significantly better OS compared to the higher CRP level group (P = 0.008). Supplementary material 1 (JPEG 938 kb)

10434_2012_2392_MOESM2_ESM.jpg

Figure S2. Survival curves in 142 OSCC patients related to the preoperative SCC-Ag level. a The lower SCC-Ag level group (<2.0 ng/ml) showed significantly better DFS compared to the higher SCC-Ag level group (≥2.0 ng/ml) (P = 0.001). b The lower SCC-Ag level group showed significantly better OS compared to the higher SCC-Ag level group (P = 0.018).Supplementary material 2 (JPEG 1009 kb)

10434_2012_2392_MOESM3_ESM.jpg

Figure S3. Scatter plot of CRP level versus SCC-Ag level (Pearson’s correlation = 0.891, P = 0.001). Supplementary material 4 (JPEG 23 kb)

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Huang, SF., Wei, FC., Liao, CT. et al. Risk Stratification in Oral Cavity Squamous Cell Carcinoma by Preoperative CRP and SCC Antigen Levels. Ann Surg Oncol 19, 3856–3864 (2012). https://doi.org/10.1245/s10434-012-2392-5

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