Combined use of established and novel tumour markers in the diagnosis of head and neck squamous cell carcinoma

Serum SCC, CYFRA 21-1, and CEA are the common tumour markers for head and neck squamous cell carcinoma (HNSCC), although diagnostic sensitivity should be yet improved, especially at early stages. In the present study, we have reported the diagnostic value of two novel serum tumor markers in HNSCC: alpha-L-fucosidase (AFU) activity, and total sialic acid concentration adjusted by total protein concentration (TSA/TP). Using the cut-off 4.0 U/ml, AFU showed a sensitivity of 55% with specificity levels of 91%, 85% and 50% to discriminate HNSCC patients from health donors, drinking and smoking subjects, and patients with benign diseases, respectively. Furthermore, AFU showed the best sensitivity (71%) in the detection of patients with premalign lesions. Using the cut-off 12.0 ng/mg, TSA/TP showed the best sensitivity levels (63%) in the diagnosis of HNSCC with specificity levels of 94%, 50%, and 90%, regarding health donors, drinking and smoking subjects, and patients with benign diseases, respectively. It was of special interest that sensitivity in the diagnosis of HNSCC at non-disseminated stages was improved when using combinations of AFU+CYFRA or TSA/TP+CYFRA, up to 86% or 71% in TNM I, 60% or 80% in TNM II, and 80% or 60% in TNM III, respectively.