Squamous cell carcinoma-antigen messenger RNA level in peripheral blood predicts recurrence after resection in patients with esophageal squamous cell carcinoma.
BACKGROUND
The aim of this study was to clarify whether preoperative squamous cell carcinoma-antigen messenger RNA (SCC-Ag mRNA) level in peripheral blood can be used to predict tumor recurrence after curative resection for esophageal squamous cell carcinoma.


METHODS
A prospective analysis was conducted for 46 consecutive patients who underwent curative esophagectomy and who had no residual tumor. The SCC-Ag mRNA level in the peripheral blood of each patient was measured preoperatively by using quantitative reverse transcriptase-polymerase chain reaction. Median follow-up period was 34 months.


RESULTS
Receiver operating characteristic analysis demonstrated that the optimal cutoff level of SCC-Ag mRNA was 40. Patients were divided into the high SCC-Ag mRNA level group (n = 14) and the low SCC-Ag mRNA level group (n = 32). The cumulative probabilities of tumor recurrence were higher in the high SCC-Ag mRNA level group (probability of recurrence was 71% at 2 years) than in the low group (22% at 2 years; P = .0005). SCC-Ag mRNA level (relative risk, 3.00; 95% confidence interval, 1.05-8.54; P = .040) was the strongest independent predictor of recurrence by multivariate analysis.


CONCLUSIONS
Preoperative SCC-Ag mRNA levels in the peripheral blood are the best predictive factor for recurrence in patients with esophageal squamous cell carcinoma who undergo curative resection (R0).
Honma
Hideyuki
H
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Japan.
Kanda
Tatsuo
T
Ito
Hiroaki
H
Wakai
Toshifumi
T
Nakagawa
Satoru
S
Ohashi
Manabu
M
Koyama
Yu
Y
Valera
Vladimir A
VA
Akazawa
Kouhei
K
Hatakeyama
Katsuyoshi
K
D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood / Q000235:genetics*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000235:genetics* / Q000401:mortality / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000097:blood / Q000235:genetics* / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012333:RNA, Messenger / Q000097:blood* / Q000235:genetics; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015843:Serpins / Q000097:blood / Q000235:genetics*; D016019:Survival Analysis
D000951:Antigens, Neoplasm; D012333:RNA, Messenger; D015843:Serpins; C051072:squamous cell carcinoma-related antigen