title: Squamous cell carcinoma-antigen messenger RNA level in peripheral blood predicts recurrence after resection in patients with esophageal squamous cell carcinoma.
abstract: 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).
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Honma
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ito
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Wakai
authors.forename: Satoru
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Manabu
authors.initials: M
authors.lastname: Ohashi
authors.forename: Yu
authors.initials: Y
authors.lastname: Koyama
authors.forename: Vladimir A
authors.initials: VA
authors.lastname: Valera
authors.forename: Kouhei
authors.initials: K
authors.lastname: Akazawa
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: 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
chemical_list: D000951:Antigens, Neoplasm; D012333:RNA, Messenger; D015843:Serpins; C051072:squamous cell carcinoma-related antigen