Squamous cell carcinoma antigen as a prognostic marker and its correlation with clinicopathological features in head and neck squamous cell carcinoma: Systematic review and meta‐analysis

Background Several studies investigate the prognostic value of squamous cell carcinoma antigen ( SCC ‐Ag) in head and neck squamous cell carcinoma ( HNSCC ) patients, with contradicting findings. Considering this, the aim of this study was to evaluate the prognostic value of high SCC ‐Ag levels and its association with clinicopathological features of HNSCC . Material and Methods PubMed, SCOPUS , and Cochrane Library were searched for relevant studies up to December 2015. English‐language publications assessing clinicopathological features of HNSCC and the prognostic significance of SCC ‐Ag in this disease were included. A meta‐analysis was performed using Review Manager 5.3 and STATA version 14 software to clarify a possible association between SCC ‐Ag and clinical outcomes. Results A total of 11 studies met inclusion criteria, comprising 1901 cases of HNSCC . The results of the meta‐analysis showed that there was significant correlation between high SCC ‐Ag levels and males (odds ratio [ OR ]=2.99, 95% CI : 1.18‐7.57, P =.02 fixed‐effect), and advanced TNM stages ( OR =3.18, 95% CI : 1.88‐5.38, P <.0001 random‐effect). The survival meta‐analysis showed a pooled hazard ratio for disease‐free survival ( DFS ) and overall survival ( OS ) of 1.01 (95% CI : 0.70‐1.31) and 0.86 (95% CI : 0.54‐1.17), respectively. Conclusion Our meta‐analysis suggests that elevated SCC ‐Ag levels have a significant correlation with males and TNM stage, but may not be used as predictive marker for OS and DFS in HNSCC patients.