In 127 cases of oral cancer, the serum tumor marker levels, and in a portion of the cases, the localization of tumor markers within the tissue were examined. The results were as follows:
1. There was a propensity for the serum SCC levels prior to treatment to be elevated with increasing tumor size as well as with progression in stage.
2. The serum IAP and SCC levels prior to treatment were significantly higher in secondary cases than in primary cases, indicating that elevated levels were related to recurrence.
3. In our department, groups with recurrence following primary treatment showed significantly higher SCC levels prior to treatment as compared to the groups without recurrence.
4. The serum IAP levels dropped significantly following preoperative therapy with a combination of chemotherapy, radiation and hyperthermia. Measurement of these levels was useful for evaluating the effectiveness of chemotherapy, radiation therapy and hyperthermia.
5. In cases showing recurrence after operative therapy, there was a statistically significant elevation in IAP levels as compared to preoperative levels 6 months and 1 year postoperatively.
There was also an elevation in SCC levels 3 months postoperatively.
6. Compared to the group without recurrence, the group with recurrence had significantly higher IAP levels at 3 and 6 months, and higher levels at 3 months postoperatively.
7. Recurrence is suspected in cases with high elevations of IAP and SCC levels 3 and 6 months postoperatively.
8. Upon immunohistological staining, IAP and CEA reacted strongly with tumor cells, indicating the border of tumor cell infiltration.
9. CEA was found in the central area of the cancer pearl. IAP was found in the surrounding regions with high cancer activity. This suggests the high sensitivity of serum IAP.
These results indicate that serum tumor marker levels and intra-tissue tumor markers are useful for asessing the pathological status, selecting the method of treatment, evaluating the effectiveness of treatment, and determining the prognosis in oral cancer.