Open AccessSCC Antigen Concentrations in Fine‐Needle Aspiration Samples to Detect Cervical Lymph Node Metastases: A Prospective Analysis
Author(s) -
Schaik Jeroen E.,
Muller Kobold Anna C.,
Laan Bernard F.A.M.,
Vegt Bert,
Hemel Bettien M.,
Plaat Boudewijn E.C.
Publication year - 2023
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/01945998221102870
Subject(s) - medicine , lymph node , histology , cytology , lymph , prospective cohort study , radiology , fine needle aspiration , head and neck squamous cell carcinoma , cancer , pathology , head and neck cancer , nuclear medicine , biopsy
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.