Squamous cell carcinoma antigen as a novel candidate marker for amniotic fluid embolism

Koike, Nobuyuki; Oi, Hidekazu; Naruse, Katsuhiko; Kanayama, Naohiro; Kobayashi, Hiroshi

doi:10.1111/jog.13453

Cited by 3 publications

(9 citation statements)

References 25 publications

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“…The diagnostic significance of SCCA in AFE has been well-documented recently (13). The authors previously reported that serum SCCA levels were 25-fold higher in women with autopsy-proven AFE (mean, 112.0 ng/ml) than in healthy controls with normal deliveries (mean, 4.4 ng/ml) (13). The SCCA test can improve discriminatory power in predicting AFE (sensitivity, 60.0%; specificity, 89.2%) (13).…”

Section: Discussionmentioning

confidence: 94%

“…The present study suggests, for the first time, to the best of our knowledge, that amniotic fluid components containing SCCA enter the maternal circulation during normal vaginal delivery, and that amniotic fluid SCCA may originate from fetal urine. First, SCCA levels in amniotic fluid were reportedly much higher than those in maternal serum, suggesting the potential clinical utility of serum SCCA level as a marker for AFE diagnosis (10,13). This fact suggests that amniotic fluid components enter the maternal circulation in patients with AFE.…”

Section: Discussionmentioning

confidence: 99%

“…Fourth, serum biomarkers including ZnCP-1, STN, IGFBP1 and SCCA are not used widely in clinical practice due to several limitations including low sensitivity, lack of standardization of methods, difficulty of measuring markers during the acute phase of an episode, and the fact that its use remains experimental (4)(5)(6)(7)(8)(9)(10)(11)(12)(13). The diagnostic significance of SCCA in AFE has been well-documented recently (13). The authors previously reported that serum SCCA levels were 25-fold higher in women with autopsy-proven AFE (mean, 112.0 ng/ml) than in healthy controls with normal deliveries (mean, 4.4 ng/ml) (13).…”

Section: Discussionmentioning

confidence: 99%

“…Although AFE remains unpredictable based on current diagnostic strategies, recent advances in molecular biology have facilitated analysis of its pathogenesis. Advances in biochemistry experiments have enabled the identification of novel serum biomarkers of amniotic fluid passage into the maternal circulation (4)(5)(6)(7)(8)(9)(10)(11)(12)(13). For example, Zinc-coproporphilin-1 (ZnCP1) (4), sialyl Tn (STN) (5,6) and insulin-like growth factor binding protein 1 (IGFBP1) (12) have been reported as substances that are extremely abundant in amniotic fluid and present in trace amounts in maternal blood.…”

Section: Introductionmentioning

confidence: 99%

“…This fact suggests that SCCA is a more valuable and reliable marker for serodiagnosis of AFE than ZnCP1, STN and IGFBP1 (9)(10)(11). In 2017, the authors reported extremely high levels of SCCA in the maternal serum of 4 patients with autopsy-proven AFE (13).…”

Section: Introductionmentioning

confidence: 99%

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Dynamic changes in the levels of maternal serum squamous cell carcinoma antigen, a potential biomarker of amniotic fluid embolism, before and after delivery in relation to the mode of delivery

et al. 2021

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Amniotic fluid embolism (AFE) is a serious disease in which amniotic fluid components enter the maternal systemic circulation, causing cardiopulmonary collapse in pregnant women. It has been previously reported that amniotic fluid contains extremely high levels of squamous cell carcinoma antigen (SCCA), and that pregnant women who do not survive due to AFE have high blood SCCA levels. The aim of the present study was to determine the possible mechanisms through which SCCA in amniotic fluid enters the maternal blood, as well as the potential origin of SCCA. The prospective study included a cohort of 464 women (339 normal vaginal deliveries, 97 cesarean deliveries without labor, and 28 cesarean deliveries with labor). The dynamic changes in maternal serum SCCA levels were determined before and after delivery in relation to the mode of delivery, and SCCA levels were measured in the placenta, fetal skin, amniotic fluid cell components, amniotic fluid and neonatal urine. Serial serum samples collected at the time of admission, at 2 h postpartum, and on postpartum day 3 were quantitatively measured for SCCA by enzyme-linked immunosorbent assay. Amniotic fluid and neonatal urine SCCA levels were also measured. The protein expression of SCCA in the placenta and fetal skin was assessed by immunohistochemistry. In vaginal deliveries, there was a significant increase in serum SCCA levels from admission to 2 h postpartum, and SCCA levels decreased on postpartum day 3. In cesarean deliveries, the SCCA levels at the time of admission and 2 h postpartum did not differ. The SCCA levels were significantly higher in women who underwent vaginal deliveries compared to those that underwent cesarean deliveries without labor (P= 0.033). Immunohistochemical staining revealed no SCCA expression in the placenta and fetal skin. The SCCA levels in neonatal urine immediately after birth were as high as those in the amniotic fluid, suggesting that SCCA may originate from fetal urine. The present study thus suggests that amniotic fluid SCCA levels, which may be derived from fetal urine, can enter the maternal circulation during vaginal delivery. The onset of labor and full cervical dilatation are the main causes of entry of amniotic fluid components into the maternal circulation.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Dynamic changes in the levels of maternal serum squamous cell carcinoma antigen, a potential biomarker of amniotic fluid embolism, before and after delivery in relation to the mode of delivery

et al. 2021

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Utility of Biomarkers for Postpartum Hemorrhage Transfusion Requirements Relating to Amniotic Fluid Embolism

Shimaoka¹,

Shiga²,

Morishige³

2023

Clin. Exp. Obstet. Gynecol.

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Background:We aimed to evaluate the utility of C1 esterase inhibitor, squamous cell carcinoma antigen, and complements C3 and C4 in the prediction of fresh frozen plasma transfusion requirements in postpartum hemorrhage and characterize the involvement of amniotic fluid embolism in the pathophysiology of postpartum hemorrhage. Methods: In this single-centered prospective observational study, consecutive patients with postpartum hemorrhage were evaluated for C1 esterase inhibitor, squamous cell carcinoma antigen, C3 and C4. We analyzed the relationship between the fresh frozen plasma transfusion volume and the above-mentioned biomarkers. The interaction of low C1 esterase inhibitor and squamous cell carcinoma antigen with respect to the fresh frozen plasma transfusion volume was analyzed. Results: The analysis included 132 patients with postpartum hemorrhage. In univariate analysis, C1 esterase inhibitor (correlation coefficient: -0.368, p < 0.001), C3 (correlation coefficient: -0.376, p < 0.001) and C4 (correlation coefficient: -0.291, p < 0.001) were negatively correlated with fresh frozen plasma transfusion volume. In multivariate analysis, only C3 was an independent factor associated with fresh frozen plasma transfusion volume (regression coefficient: -0.173, p = 0.022). C3 had the highest area under the curve (0.843) and cut-off value (80 mg/dL) for the prediction of fresh frozen plasma transfusion of ≥15 units. The fresh frozen plasma transfusion volume was higher in patients with low C1 esterase inhibitor and high squamous cell carcinoma antigen in the interaction analysis. Conclusions: Measuring C1 esterase inhibitor, squamous cell carcinoma antigen, and complements C3 and C4 in postpartum hemorrhage may allow assessment of the extent of anaphylactoid reaction and the requirement for fresh frozen plasma transfusion.

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The Non-Cancer Specific Elevation of the Serum Squamous Cell Carcinoma Antigen during the Post-Radiotherapy Follow-Up of Cervical Cancer Patients

Oike

Ando

et al. 2021

Diagnostics

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The elevation of the serum squamous cell carcinoma (SCC) antigen unrelated to disease progression occurs during the follow-up of patients with cervical cancer treated with radiotherapy. Although known empirically, the incidence and characteristics of this non-cancer specific elevation in SCC remain unclear. Here, we examined the post-treatment kinetics of SCC in 143 consecutive patients with squamous cell carcinoma of the cervix treated with definitive radiotherapy; in all patients, progression-free disease status was confirmed by periodic monitoring for at least 36 months (median, 61 months). We found that the 5-year cumulative incidence of post-treatment SCC elevation was unexpectedly high at 37.3% (59/143 patients), and that 59.3% (35/59) of event-positive patients experienced multiple events. The median peak SCC level for a given event was 2.0 ng/mL (interquartile range, 1.7–2.9 ng/mL). The multivariate analysis showed that renal dysfunction was associated significantly with a greater incidence of SCC elevation (p = 0.046). In addition, the 5-year cumulative incidence of SCC elevation was significantly greater in patients with renal dysfunction than in those without (54.8% vs. 32.9%, respectively; hazard ratio, 2.1 [95% confidence interval, 1.1–4.2]; p = 0.028). These data will be useful for monitoring cervical cancer patients treated with radiotherapy.

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Squamous cell carcinoma antigen as a novel candidate marker for amniotic fluid embolism

Abstract: Serum SCC antigen may be a promising predictor of the entry of amniotic fluid into the maternal circulation, potentially serving as a candidate marker for noninvasive diagnosis of AFE.

Cited by 3 publications

References 25 publications

Dynamic changes in the levels of maternal serum squamous cell carcinoma antigen, a potential biomarker of amniotic fluid embolism, before and after delivery in relation to the mode of delivery

Dynamic changes in the levels of maternal serum squamous cell carcinoma antigen, a potential biomarker of amniotic fluid embolism, before and after delivery in relation to the mode of delivery

Utility of Biomarkers for Postpartum Hemorrhage Transfusion Requirements Relating to Amniotic Fluid Embolism

The Non-Cancer Specific Elevation of the Serum Squamous Cell Carcinoma Antigen during the Post-Radiotherapy Follow-Up of Cervical Cancer Patients

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