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 c...

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Bibliographic Details
Published in:Surgery 2003-05, Vol.133 (5), p.486-494
Main Authors: Shimada, Hideaki, Nabeya, Yoshihiro, Okazumi, Shin-ichi, Matsubara, Hisahiro, Shiratori, Tooru, Gunji, Yoshio, Kobayashi, Susumu, Hayashi, Hideki, Ochiai, Takenori
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antigens, Neoplasm - analysis
Biological and medical sciences
Carcinoembryonic Antigen - analysis
Carcinoma, Squamous Cell - immunology
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Disease Progression
Esophageal Neoplasms - immunology
Esophageal Neoplasms - pathology
Esophageal Neoplasms - surgery
Esophagectomy
Esophagus
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Lymph Node Excision
Male
Medical sciences
Middle Aged
Neoplasm Staging
Osmolar Concentration
Postoperative Period
Prognosis
Serpins
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Survival Analysis
Tumors
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Summary: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
ISSN:0039-6060
1532-7361
DOI:10.1067/msy.2003.139