OncoTargets and Therapy (May 2020)
Clinical Value of Tumor Marker Index Based on Preoperative CYFRA 21-1 and SCC-Ag in the Evaluation of Prognosis and Treatment Effectiveness in Patients with Esophageal Squamous Cell Carcinoma
Abstract
Nanchang Yin,1 Wei Liu2 1Department of Thoracic Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, People’s Republic of China; 2Department of Medical Oncology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, People’s Republic of ChinaCorrespondence: Wei LiuDepartment of Medical Oncology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, People’s Republic of ChinaTel +86 416-4673536Fax +86 416-4580464Email [email protected]: This study aimed to investigate the prognostic value of tumor marker index (TMI) based on preoperative cytokeratin 19 fragment (CYFRA 21– 1) and squamous cell carcinoma antigen (SCC-Ag) and the relationship between preoperative TMI and treatment effectiveness of postoperative adjuvant chemotherapy for patients with esophageal squamous cell carcinoma (ESCC).Patients and Methods: Between January 2009 and December 2014, a total of 267 patients with ESCC who underwent radical resection were retrospectively enrolled. The TMI was defined as the geometric mean of normalized CYFRA 21– 1 and SCC-Ag levels. The clinical and prognostic values of TMI were determined using univariate and multivariate survival analyses.Results: Preoperative TMI level was associated with age, tumor size, pT stage, pN stage, and CYFRA 21– 1, SCC-Ag, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) levels. The 5-year overall survival rate of patients with high TMI was significantly lower than that of patients with low TMI (P < 0.001). Univariate and multivariate analyses revealed that TMI (P = 0.031) was an independent prognostic factor. Patients with ESCC with high TMI level who underwent surgery combined with postoperative chemotherapy had a significantly better prognosis than those who underwent surgery alone (P = 0.015). However, no significant difference was observed in patients with low TMI level (P = 0.682).Conclusion: TMI as a prognostic indicator of ESCC is superior to CYFRA 21– 1 and SCC-Ag. The TMI might be useful in predicting the therapeutic effectiveness of postoperative chemotherapy and selecting patients who may benefit from postoperative chemotherapy.Keywords: esophageal squamous cell carcinoma, CYFRA 21-1, SCC-Ag, tumor marker index, adjuvant chemotherapy
