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血清鳞状细胞癌抗原对复发性食管鳞状细胞癌患者的临床意义。

Clinical Significance of Serum Squamous Cell Carcinoma Antigen for Patients with Recurrent Esophageal Squamous Cell Carcinoma.

机构信息

Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, 135-8550, Japan.

出版信息

Ann Surg Oncol. 2021 Nov;28(12):7990-7996. doi: 10.1245/s10434-021-09945-5. Epub 2021 Apr 10.

Abstract

BACKGROUND

Squamous cell carcinoma antigen (SCC-Ag) is a widely used tumor marker of SCC. However, the clinical significance of serum SCC-Ag levels in recurrent esophageal SCC (ESCC) remains unclear. This study aimed to investigate the clinical relevance of serum SCC-Ag levels in patients with recurrent ESCC after surgery.

METHODS

This study retrospectively analyzed 208 patients who experienced recurrence after curative resection for ESCC. Serum SCC-Ag levels at the time of recurrence were collected from the patients' records. The patients were classified into tertiles based on the serum SCC-Ag values (low, middle, and high), and the clinical characteristics and outcomes were compared among the groups.

RESULTS

Significant differences in sex (p = 0.001), pathologic T (p = 0.034), and N stages of primary cancer (p = 0.015) were observed among the groups. Although the recurrence patterns did not differ significantly, a high SCC-Ag was significantly associated with multiple recurrences (p = 0.019). The high-SCC-Ag group patients demonstrated a shorter time to recurrence than the other groups (p = 0.044). The SCC-Ag levels were significantly associated with overall survival after recurrence (p = 0.036). Multivariate analysis showed that serum SCC-Ag value at recurrence was an independent poor prognosticator (p = 0.031).

CONCLUSION

Elevated serum SCC-Ag levels at recurrence were significantly associated with a reduced time to recurrence, multiple recurrences, and a poor prognosis after recurrence. An alternative to the current standard treatment is required to improve the outcome for patients with high serum SCC-Ag levels at recurrence.

摘要

背景

鳞状细胞癌抗原(SCC-Ag)是鳞状细胞癌(SCC)广泛使用的肿瘤标志物。然而,手术后复发性食管鳞状细胞癌(ESCC)患者血清 SCC-Ag 水平的临床意义尚不清楚。本研究旨在探讨术后复发性 ESCC 患者血清 SCC-Ag 水平的临床相关性。

方法

本研究回顾性分析了 208 例经根治性切除术治疗后复发的 ESCC 患者。从患者的病历中收集复发时的血清 SCC-Ag 水平。根据血清 SCC-Ag 值将患者分为三部分(低、中、高),比较各组的临床特征和结局。

结果

各组之间在性别(p = 0.001)、病理 T 分期(p = 0.034)和原发性癌症 N 分期(p = 0.015)方面存在显著差异。尽管复发模式无显著差异,但高 SCC-Ag 与多发复发显著相关(p = 0.019)。高 SCC-Ag 组患者的复发时间短于其他组(p = 0.044)。SCC-Ag 水平与复发后的总生存时间显著相关(p = 0.036)。多变量分析显示,复发时血清 SCC-Ag 值是独立的预后不良因素(p = 0.031)。

结论

复发时血清 SCC-Ag 水平升高与复发时间缩短、多发复发和复发后预后不良显著相关。需要替代当前的标准治疗方法来改善复发时血清 SCC-Ag 水平高的患者的预后。

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