Role of SCCA and CYFRA 21-1 in the differential diagnosis of sinonasal benign and malignant diseases.

Objectives: In previous study, we have found that preoperative serum squamous cell carcinoma antigen (SCCA) and cytokeratin 19 fragment antigen 21-1(CYFRA 21-1) could be used as serum tumor markers for the diagnosis of sinonasal inverted papilloma (SNIP). Thus, we detected the expression of SCCA and CYFRA 21-1 in tumor tissue and serum to further demonstrate the role of SCCA and CYFRA21-1 in SNIP and other differential diseases.

Methods: Clinical data including gender, age, and preoperative serum SCCA and CYFRA 21-1 levels were obtained respectively from 34,91,59 patients with chronic rhinosinusitis with nasal polyps (CRSwNP), SNIP, and sinonasal squamous cell carcinoma (SNSCC). A total of 10 healthy middle turbinate (MT) tissues,12 nasal polyps (NP), 25 SNIP tissues and 15 SNSCC tissues were collected to explore the expression of SCCA and CYFRA 21-1 by quantitative real-time polymerase chain reaction (RT-qPCR) and immunohistochemistry (IHC). Employing logistic regression analysis to identify serum tumor markers, facilitating the diagnosis of both benign and malignant sinus conditions.

Results: Among these groups, SNIP groups had the highest serum SCCA expression, and the highest CYFRA 21-1 serum level was in SNSCC patients. The RT-qPCR and IHC results suggested that the expression of SCCA in the tissues of SNIP patients was still higher than that in other groups, but the immunohistochemical results of CYFRA 21-1 in SNSCC groups were different from the preoperative serum tests and RT-qPCR results. The logistic regression analysis revealed that serum SCCA and CYFRA 21-1 were risk factors for the diagnosis among three groups.

Conclusions: This study provided a more sufficient basis that SCCA and CYFRA 21-1 could be identified as a tumor marker to distinguish patients with CRSwNP, SNIP and SNSCC.