Clinical significance of serum carcinoembryonic antigen, carbohydrate antigen 19-9, and squamous cell carcinoma antigen levels in esophageal cancer patients

Serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and squamous cell carcinoma (SCC) antigen levels were assessed to determine if their levels are useful for staging esophageal cancer preoperatively and for predicting patient survival after esophagectomy. Hence their seropositivity was investigated for a correlation with resectability, clinicopathologic parameters of tumor progression, and treatment outcomes in patients with unresectable esophageal cancer (n=63) and those undergoing esophagectomy for resectable disease (n=267). Abnormal elevation of serum SCC antigen levels showed a significant correlation with resectability (p<0.0001), depth of tumor invasion (p<0.0001), lymph node status (p=0.0015), TNM stage (p<0.0001), lymphatic invasion (p=0.0019), blood vessel invasion (p=0.0079), and poor survival after esophagectomy (p=0.0061). A significant relation (p=0.0145) was found between elevated serum CEA levels and distant metastasis, whereas the seropositivity of CA 19-9 showed no association with resectability, tumor progression, or patient survival. These results indicate that abnormal elevation of serum SCC antigen is a useful predictor of advanced esophageal cancer associated with poor survival after esophagectomy.