| Background and objective : Squamous cell carcinoma antigen(SCCAg)and squamous cell carcinoma are closely related.According to the data of several studies,currently,the correlations of SCCAg and squamous cell carcinoma that express in the multiple areas of the invasion,metastasis and recurrence and prognosis about tumour are widely used in the study of cervical cancer,lung cancer,laryngeal cancer,nasopharyngeal carcinoma and other various parts of squamous cell carcinoma(SCC).Although the nasal inverted papilloma is benign tumors but closely associate with squamous cell carcinoma,the aim of this study was to discuss whether the correlations between the level of Serum SCCAg and nasal inverted papilloma can be serve as diagnostic markers of patients with nasal inverted papilloma about preoperative diagnosis and postoperative follow-up.By comparing the levels of SCCAg in patients with nasal inverted papilloma,and patients with inflammatory diseases,we explore explore the role of serum SCCAg in the diagnosis of the NIP,and determine the expression and its significance of serum squamous cell carcinoma antigen(SCCAg)for NIP recurrence.Methods:Random 37 patients with inverted papilloma admitted in our department in January 2012 to July 2016 were chosed,who were all confirmed by histopathologic diagnosis for the NIP.The male 29 cases,female 8 cases,their average age is 58.7 years old,and they all suffer from a single tumor,don't have other interference disease such as concurrent liver and kidney disease,tuberculosis,adult respiratory distress syndrome,psoriasis and eczema.Control group is 45 patients with nasal inflammation,including patients with chronic sinusitis,nasal polyps,fungal sinusitis patients and patients chronic rhinitis.The patients' s venous blood were extractd and used to mensurate serum SCCAg level that mensurated by Maglumi2000 automatic ChemiLuminescence immune analyzer and its marching kits,these are all produced by new industrial company in shenzhen,for 37 patients with NIP(NIP group)and 45 with inflammatory disease(inflammatory group).The operation professionals and technical personnels from clinical laboratory of this hospital are responsible for the whole process of inspection,according to manufacturer instructions.The patients in NIP group were all asked to go to hospital to measure their serum SCCAg at preoperative 1 week,postoperative 1 week and 3 mouths.Evaluation standard: ? 2.5 ng/mL is negative,> 2.5 ng/mL is positive,the patient's data is analyseed by SPSS 22.0 statistical soft packet,according to the distribution characteristics,double end respectively Pearson chi-square test or Fisher's exact test,the Mann-Whitney U test and Wilcoxon signed rank test and t test statistical analysis are used for different data,In multivariate logistic analysis to identify independent risk factors with an effect on preoperative SCCA elevation in these patients with NIP,the final model showed that pathological pattern was a predictor of SCCA elevation.Results: Of 37 NIP cases,21 patients(83.3%)showed elevated serum SCCA levels,specificity was 93.3%,positive predictive value was 88.0%,negative predictive value was 88.0%,Youden index index was 52.8%,the receiver working characteristic curve analysis(ROC curve)SCCAg level produced by the area under the curve is 0.902(figure 1).the patients with nasal inverted papilloma has obvious difference with control group in levels of serum SCCAg(P < 0.05),59.5% in the IP group showed abnormaliy elevated serum SCCA levels regardless of whether they were new patients or patients with recurrent IP.Only 6.7% had abnormaliy elevated SCCA levels in the inflammatory group.Preoperative serum squamous cell carcinoma antigen(SCCAg)levels in the nasal inverted papilloma group was significantly different with inflammatory group,the single factor analysis showed that the rate of positive preoperative serum SCCAg value is independent of the sex,age and grade of Krouse stage,recurrent cases,smoking habits,tumor primary side(P > 0.05).Preoperative SCCAg levels in nasal inverted papilloma groups are releated to pathological classification,as well as the size of the tumors and Kamel stages.In multivariate logistic analysis to identify independent risk factors with an effect on preoperative SCCA elevation in these 37 patients with NIP,the final model showed that pathological pattern was a predictor of SCCA elevation(p = 0.025;odds ratio,14.87),the remaining two p values failed to reach p < 0.05 standard of statistical significance.The level in patients with nasal inverted papilloma after surgery for 1 week was significantly lower than the preoperative level.(P < 0.05),but after 3 months the SCCAg level in inverted papilloma groups increased significantly(P < 0.05).Conclusion: 1.SCCAg and nasal inverted papilloma are related obviously,which may make SCCAg for progression and prognostic indicators.Especially distinguishing with the new oncome or recurrence cases with both nasal sinusitis patients and nasai inverted papilloma and the single sinusitis patients is of great significance.2.SCCAg closely associating with relapse,this can be as an index,identifies patients with high risk of recurrence,the surgeon will formulate reasonable review scheme after surgery,which is of great significance.For early detection of disease,early treatment is important.3.This study suggests that the level of serum SCCAg closely associated with pathological types,but the origin area of tumor(this study analyzes the relations between the Kamel staging and SCCAg)and the volume of the tumor were confirmed that these two factors had positive correlation with the levels of SCCAg in the single factor analysis,but when in multiple factors analysis these factors failed to meet P < 0.05,which may be by reason of the insufficient amount of sample,it is worth continuing to study in the future research.4.This study also aimed at the correlation between the smoking and nasal squamous cell carcinoma antigen,and between Krouse classification and nasal squamous cell carcinoma antigen,in patients with NIP,the result show that smoking and Krouse classification has no correlation with the rise of SCCAg,some scholars' reports pointed out that these two factors are closely associated with the rise of SCCAg,which may be also due to the lack of enough sample.We can continue to study these factors in the future research.5.Serum SCCAg as the tumor markers,its sensitivity was 59.5%,the effect is not ideal for stand-alone diagnosis,to increase the positive rate of diagnosis other tumor markers can be consider to join in future research... |
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