Original Article
Roles of squamous cell cancer antigen, cytokeratin 21-1 fragment, and carcinoembryonic antigen in the diagnosis and prognosis of postoperative locoregional recurrence in esophageal carcinoma
Abstract
Background: Locoregional recurrence (LR) is the major cause for poor response after radical resection in patients with esophageal carcinoma (EC). Therefore, early diagnosis and positive treatment is crucial for the extension of overall survival in EC patients. We aim to investigate the feasibility of squamous cell cancer antigen (SCC-Ag), cytokeratin 21-1 fragment (CYFRA21-1), and carcinoembryonic antigen (CEA) in the diagnosis of postoperative LR in patients with EC, and the correlation between their expression and the prognosis of the disease.
Methods: Sixty-two EC patients with postoperative LR were included, and thirty normal individuals served as normal control. Serum SCC-Ag, CYFRA21-1and CEA were determined before and one month after treatment. SCC-Ag level was evaluated using chemiluminescent microparticle immunoassay. CYFRA21-1 was determined using the chemiluminescence assay. CEA was determined using the direct chemiluminescence assay. The patients received radiotherapy and/or chemoradiotherapy. The survival rates were measured using Kaplan-Meier method, and was tested using Logrank analysis. Multiple logic regression analysis was used for the analysis of prognostic factors.
Results: Remarkable elevation was noticed in serum SCC-Ag (t=4.79, P<0.05) and CYFRA21-1 (t=7.86, P<0.05) in patients with postoperative LR compared with those of the normal individuals. The positive rates of serum SCC-Ag and CYFRA21-1 were 67.7% and 69.4%, respectively. No remarkable difference was noticed in the expression of serum CEA in the patients with postoperative LR compared with the normal control (P>0.05). The SCC-Ag and CYFRA21-1 other than CEA were related to the pathological staging of EC patients with postoperative LR. The median overall survival was 12.0 months (95% CI, 8.98–15.02). The survival rates at 1, 2, 3 and 5 years were 46.1%, 19.7%, 12.3%, and 8.2%, respectively. The serum SCC-Ag and CYFRA21-1 were decreased after radiotherapy and/or chemoradiotherapy in patients with postoperative LR (t=3.24, P<0.05; t=3.79, P<0.05). Whereas, no statistical difference was noted in the serum CEA after treatment compared with the baseline level (P>0.05). Among the EC patients with postoperative LR before radiotherapy or chemoradiotherapy, the survival of patients negative for SCC-Ag and CYFRA21-1 showed significantly longer disease-free interval compared to those for these markers (χ2=5.92, P<0.05; χ2=4.92, P<0.05). Among the EC patients with postoperative LR after radiotherapy or chemoradiotherapy, the survival of patients negative for SCC-Ag showed signifcantly longer disease-free interval compared to that with positivity for this marker (χ2=5.30, P<0.05). Multiple logic regression analysis indicated no independent risk factors for the postoperative LR of patients with EC.
Conclusions: Our results indicate that serum SCC-Ag and CYFRA21-1 contribute to the diagnosis of postoperative LR in EC patients. Besides, radiotherapy and/or chemotherapy is beneficial to the extension of survival in these patients.
Methods: Sixty-two EC patients with postoperative LR were included, and thirty normal individuals served as normal control. Serum SCC-Ag, CYFRA21-1and CEA were determined before and one month after treatment. SCC-Ag level was evaluated using chemiluminescent microparticle immunoassay. CYFRA21-1 was determined using the chemiluminescence assay. CEA was determined using the direct chemiluminescence assay. The patients received radiotherapy and/or chemoradiotherapy. The survival rates were measured using Kaplan-Meier method, and was tested using Logrank analysis. Multiple logic regression analysis was used for the analysis of prognostic factors.
Results: Remarkable elevation was noticed in serum SCC-Ag (t=4.79, P<0.05) and CYFRA21-1 (t=7.86, P<0.05) in patients with postoperative LR compared with those of the normal individuals. The positive rates of serum SCC-Ag and CYFRA21-1 were 67.7% and 69.4%, respectively. No remarkable difference was noticed in the expression of serum CEA in the patients with postoperative LR compared with the normal control (P>0.05). The SCC-Ag and CYFRA21-1 other than CEA were related to the pathological staging of EC patients with postoperative LR. The median overall survival was 12.0 months (95% CI, 8.98–15.02). The survival rates at 1, 2, 3 and 5 years were 46.1%, 19.7%, 12.3%, and 8.2%, respectively. The serum SCC-Ag and CYFRA21-1 were decreased after radiotherapy and/or chemoradiotherapy in patients with postoperative LR (t=3.24, P<0.05; t=3.79, P<0.05). Whereas, no statistical difference was noted in the serum CEA after treatment compared with the baseline level (P>0.05). Among the EC patients with postoperative LR before radiotherapy or chemoradiotherapy, the survival of patients negative for SCC-Ag and CYFRA21-1 showed significantly longer disease-free interval compared to those for these markers (χ2=5.92, P<0.05; χ2=4.92, P<0.05). Among the EC patients with postoperative LR after radiotherapy or chemoradiotherapy, the survival of patients negative for SCC-Ag showed signifcantly longer disease-free interval compared to that with positivity for this marker (χ2=5.30, P<0.05). Multiple logic regression analysis indicated no independent risk factors for the postoperative LR of patients with EC.
Conclusions: Our results indicate that serum SCC-Ag and CYFRA21-1 contribute to the diagnosis of postoperative LR in EC patients. Besides, radiotherapy and/or chemotherapy is beneficial to the extension of survival in these patients.
