Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, 135-8550, Japan.
Ann Surg Oncol. 2021 Nov;28(12):7990-7996. doi: 10.1245/s10434-021-09945-5. Epub 2021 Apr 10.
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.
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.
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).
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.
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。
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。
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)。
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。