Clinical Significance of Measurement of Tumor Markers for Esophageal Squamous Cell Carcinoma -A Retrospective Analysis in Recurrent Cases-

Hidetoshi Makita, Masahiko Murakami, Tetsuo Sawatani, Koji Otsuka, Yoshihiro Fukoue, Takashi Kato and Mitsuo Kusano

Department of General and Gastroenterological Surgery, Showa University School of Medicine

Introduction: We studied clinical significance based on the courses of tumor markers following surgery for esophageal squamous cell carcinoma. Method: Tumor markers (CEA, SCC and CYFRA21-1) were measured in 55 cases of resected esophageal squamous cell carcinoma before and after surgery. The markers were measured every 3 months postoperatively. Recurrence appeared in 23 cases. Results: The tumor marker showing the highest preoperative positivity was CYFRA21-1 at 30.1%, and it correlated with pathological cancer depth (pT) and prognosis. Positivity in all cases increased significantly with the combination of all 3 markers. Nine cases proving positive for both SCC and CYFRA21-1 suffered postoperative recurrences, which in 8 cases involved lymph node metastasis. Conclusion: Combined CEA, SCC and CYFRA21-1 assay is very useful for diagnosing esophageal squamous cell carcinoma, and is also useful for recurrences. For preoperatively positive CYFRA21-1, it appears that other therapies (chemotherapy and/or radiation therapy) should be conducted postoperatively, even after curative surgery. When both SCC and CYFRA21-1 become positive postoperatively, the possibility of recurrence, especially lymph node metastasis, is very high. Positivity in a combination assay of the 3 tumor markers, even without imaging findings, is suggestive of a recurrence; indicative that tumor markers need to be studied frequently.

Key words
tumor marker, esophageal carcinoma, squamous cell carcinoma, combination assay, CYFRA21-1

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Hidetoshi Makita Department of General and Gastroenterological Surgery, Showa University School of Medicine
1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 JAPAN

Accepted
May 25, 2004

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