SCC Tumour Marker — MFDS Part 1 MCQ

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HardOral PathologySCC Tumour MarkerMFDS Part 1

A 61-year-old man has an ulcerated lateral tongue tumour. Histology shows invasive nests of atypical polygonal epithelial cells with keratin pearls and intercellular bridges. After definitive treatment, a serpin-family serum tumour marker is measured serially; a rising concentration may be associated with recurrent disease. Which tumour marker is being measured?

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Correct answer: B — SCC antigen

The histological features identify a keratinising oral squamous cell carcinoma. SCC antigen, comprising the serpin proteins SCCA1 and SCCA2, may be elevated in head and neck squamous cell carcinoma. Serial concentrations can fall following successful treatment and rise with recurrence, although the marker lacks sufficient accuracy for screening and is not a substitute for standard clinical and imaging surveillance. CA-125 is principally associated with epithelial ovarian malignancy, PSA with prostatic disease, and AFP with hepatocellular and non-seminomatous germ-cell tumours. CEA is a relatively non-specific marker used mainly in the follow-up of selected adenocarcinomas and is not the characteristic serpin-family marker described here.

Reference: Zhu H. Squamous Cell Carcinoma Antigen: Clinical Application and Research Status. Diagnostics. 2022;12:1065. https://pubmed.ncbi.nlm.nih.gov/37694613/