Usefulness of Monitoring Blood CEA and SCC Antigen When Following Up Patients after Surgery for Esophageal Cancer

Hajime Ikuta, Yutaka Hamabe, Kouichi Narita, Tsutomu Shiraishi, Toshihiko Matsuura, Masahiro Nishida, Masato Oosawa, Masahiro Yamamoto, Yoichi Saitoh

First Department of Surgery, Kobe University School of Medicine

Blood levels of CEA and SCC antigen were measured in 52 patients after surgery for esophageal cancer. The CEA and SCC antigen positive rates and the time course of each antigen level were analyzed in relation to tumor recurrence. Furthermore, the usefulness of a combination assay, involving both atnigens, was assessed. For the 23 cases, in which there was tumor recurrence after surgrey, CEA had a sensitivity of 56.5%, a specificity of 89.7% and an accuracy of 75.0%. SCC antigen had a sensitivity, specificity and accuracy of 60.9%, 93.1%, 87.8%, respectively. The combination of the two antigens had a sensitivity, specificity and accuracy of 78.3%, 86.2% and 82.7%. Thus, the sensitivity was increased by combining the two parameters. Preoperative positive rates were low (CEA: 15.6% or 7/45; SCC: 13.5% or 5/37). In 5 cases, where both antigens were positive preoperatively and a tumor recurred postoperatively, the antigen levels normalized for a time after surgery and rose again upon tumor recurrence. There were 11 cases in which CEA was negative preoperatively but became positive upon tumor recurrence and 8 cases in which SCC antigen followed a similar course. In two cases, antigen levels reflected the response of recurrent tumors to treatment. Measuring both CEA and SCC antigen appears to be useful in following up patients after surgery for esophageal cancer.

Key words
esophageal cancer, postoperative follow-up, tumor marker, carcinoembryonic antigen, squamous cell carcinoma related antigen

Reprint requests
Hajime Ikuta First Department of Surgery, Kobe University School of Medicine
7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650 JAPAN

Accepted
July 10, 1996

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