title: Preoperative Cyfra21-1 and SCC-Ag serum titers predict survival in patients with stage II esophageal squamous cell carcinoma.
abstract: BACKGROUND
  The purpose of this study is to evaluate the predictive significance of preoperative serum level of cytokeratin 19 fragments (Cyfra21-1) and squamous cell carcinoma antigen (SCC-Ag) after complete resection in patients with stage II esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  Between 1995 and 2006, a total of 379 patients in stage II ESCC who underwent complete resection were consecutively recruited. Statistical analyses were applied to test the associations between preoperative serum titers of Cyfra21-1 and SCC-Ag, clinicopathological factors and prognoses.
  
  
  RESULTS
  Preoperative high and normal serum level of Cyfra21-1 and SCC-Ag were found in 47.8%, 52.2% and 72.8%, 27.2%, respectively. The 1-, 3-, 5-year overall survival rate for the entire cohort of patients was 95%, 78%, and 56%, respectively. Median overall survival (OS) was 45.3 months longer in patients with low preoperative serum level of Cyfra21-1 (91.9 months) than those with high preoperative serum level of Cyfra21-1 (46.6 months) (P < 0.001). Median OS among patients with SCC-Ag-low level was also longer than those with SCC-Ag-high level (89.7 vs. 63.7 months, P < 0.001), especially for those with stage IIB (P < 0.001). After multivariate analysis, along with pTNM stage, preoperative serum level of Cyfra21-1 and SCC-Ag were independently and significantly predictive factors (P < 0.001, P < 0.001). Furthermore, the five-year survival rate in double-low subset, either-low subset and double-high subset was 100%, 83% and 27%, respectively (P < 0.001).
  
  
  CONCLUSIONS
  The preoperative serum level of Cyfra21-1 and SCC-Ag are independently significant predictors which negatively affected the survivals of patients with stage II ESCC.
authors.affiliation: State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, No,651, Dongfeng Road East, 510060, Guangzhou, China. mr.caoxun@gmail.com
authors.forename: Xun
authors.initials: X
authors.lastname: Cao
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.forename: Gui-Rong
authors.initials: GR
authors.lastname: Feng
authors.forename: Juan
authors.initials: J
authors.lastname: Yang
authors.forename: Ruo-Yan
authors.initials: RY
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Zheng
authors.forename: Yu-Jing
authors.initials: YJ
authors.lastname: Han
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D053539:Keratin-19 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D015843:Serpins / Q000097:blood*
chemical_list: D000951:Antigens, Neoplasm; D053539:Keratin-19; D015843:Serpins; C102012:antigen CYFRA21.1; C051072:squamous cell carcinoma-related antigen