Comparative analysis of serum SCC antigen levels in inverted sinonasal papilloma and nasal polyps: a diagnostic meta-analysis.

PURPOSE: To systematically evaluate the association between serum squamous cell carcinoma antigen (SCCA) levels and Inverted Sinonasal Papilloma (ISP) or nasal polyps (NP), and to determine the diagnostic and prognostic utility of SCCA in these conditions.

METHODS

We performed this diagnostic meta-analysis under IRB approval, following the PRISMA and Cochrane guidelines. We searched PubMed, Embase, and Web of Science (January 2004-January 2025) without language restrictions, screened titles and abstracts, and included eight observational studies. Two groups of reviewers independently extracted data and assessed quality using NOS and QUADAS‑2.

RESULTS

Eight studies (n = 387) were included. The findings from our pairwise meta-analyses demonstrate a compelling association between elevated serum SCCA levels and ISP (pooled OR, 3.75; 95% CI, 2.45-5.00). Diagnostic accuracy meta-analyses yielded a pooled sensitivity of 82% (95% CI 73-89), specificity of 95% (95% CI 90-97), positive likelihood ratio of 16.0 (95% CI 8.5-30.2), and negative likelihood ratio of 0.19 (95% CI 0.12-0.29). The summary diagnostic odds ratio was 85 (95% CI 38-186), and the area under the sROC curve was 0.96 (95% CI 0.94-0.98). Heterogeneity was low (I2 ≤ 17%), and sensitivity, assay platform, timing, threshold, and geographic subgroup analyses confirmed the robustness of these findings. The findings from our pairwise meta-analyses demonstrate a compelling association between elevated serum SCCA levels and ISP, with a significant odds ratio (OR) of 3.75 (95% CI [2.45, 5]).

CONCLUSION

Serum SCCA levels exhibit strong diagnostic accuracy for distinguishing inverted sinonasal papilloma from other sinonasal conditions and offer a useful biomarker for monitoring disease progression and recurrence following treatment. Certainty of evidence was graded as high for diagnostic accuracy according to GRADE framework.