Oral Squamous Cell Carcinoma: Diagnosis and Prognosis Using Carcinoembryonic Antigen as a Tumor Marker

Background: Squamous cell carcinoma of the oral cavity comprises 90% to 95% of oral malignancies worldwide. In Bangladesh, it has also a high incidence rate. Early diagnosis of oral squamous cell carcinoma can save many lives. Early diagnosis of oral squamous cell carcinoma by serum tumor marker is very important for proper management of the disease.  Objective: This study was conducted to find out the co-relationship between carcinoembryonic antigen and oral squamous cell carcinoma.  Methods: A cross-sectional study of 30 patients were histopathologically diagnosed oral squamous cell carcinoma, admitted in Oral and Maxillofacial Surgery department of Bangabandhu Sheikh Mujib Medical University and Dhaka Dental College Hospital, fulfilling the inclusion & exclusion criteria. To detect the CEA, serum was collected from the patient, inserted into the monoclonal antibody containing reaction vessels of AxSYM system machine. Antigen-antibody complex formed, subsequently washed to remove unbound material, was transferred to the matrix cell where Alkalinephosphatase was added. Furthermore, washed to remove unbound material. Fluorescent product, 4-methylumbelliferyl phosphate was added and measured by the Micropartical enzyme immuno assay optical assembly (MEIA)  Results: In this study, out of 30 cases of oral squamous cell carcinoma patient, majority of the patients were female (56.7%), and mostly from the age group of 51-60 yrs. Most frequent site of the lesion was buccal mucosa (50%), and size of the lesion ranging from 4x3cm2 to 1.5x 2 cm2 . Histopathologically, more than half (60%) of the patients had Grade II lesion, and 50% of the patients had level II lymph node involvement of the neck. The postoperative value of CEA remarkably decreased in comparison to the preoperative value, which is statistically significant (p<0.05).  Conclusion: After treatment, a sustained increase in circulating CEA is highly suggestive of residual or concealed metastatic illness. Poor therapeutic response and advancing malignant illness may be linked to a continuously increasing CEA value. A positive prognosis and a satisfactory response to treatment are typically indicated by a lowering CEA reading. As a result, CEA is crucial to the diagnosis and outcome of oral squamous cell cancer.