Prediction of survival with squamous cell carcinoma antigen in patients with resectable esophageal squamous cell carcinoma.
BACKGROUND
Increased preoperative serum squamous cell carcinoma antigen (SCC-Ag) concentrations have been found to be associated with advanced stage and poor prognosis in lung and cervical cancers. Because little was known about the significance of SCC-Ag concentration in patients with esophageal cancer, the aim of this study was to analyze the clinicopathologic significance of SCC-Ag in patients with esophageal SCC. PATIENTS AND METHODS. Preoperative SCC-Ag concentration was measured with enzyme-linked immunosorbent assay in 309 patients with primary esophageal SCC. All patients underwent curative radical surgery without any preoperative therapy. In 215 of 309 patients, carcinoembryonic antigen (CEA) was also measured to compare clinical significance of CEA with that of SCC-Ag. The prognostic significance for survival of SCC-Ag concentrations was studied with multivariate analysis with Cox proportional hazards model.


RESULTS
The SCC-Ag concentration and the positivity rate of SCC-Ag were significantly elevated in patients associated with tumor progression. Statistically significant differences in SCC-Ag concentrations and SCC-Ag positivity rates were observed depending on tumor size, tumor depth, lymph node status, and distant metastasis. Although CEA was not a prognostic factor (P =.21), a high SCC-Ag concentration was a significant prognostic factor (P <.01). Multivariate analyses indicated that T factor had the best predictive power, but SCC-Ag concentration contained additional, independent prognostic information.


CONCLUSIONS
Our findings suggest that preoperative serum SCC-Ag concentrations might provide a predictive information for tumor progression and survival in patients with esophageal SCC.
Shimada
Hideaki
H
Department of Academic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Nabeya
Yoshihiro
Y
Okazumi
Shin-ichi
S
Matsubara
Hisahiro
H
Shiratori
Tooru
T
Gunji
Yoshio
Y
Kobayashi
Susumu
S
Hayashi
Hideki
H
Ochiai
Takenori
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009994:Osmolar Concentration; D011184:Postoperative Period; D011379:Prognosis; D015843:Serpins; D016019:Survival Analysis
D000951:Antigens, Neoplasm; D002272:Carcinoembryonic Antigen; D015843:Serpins; C051072:squamous cell carcinoma-related antigen