Correlation between Serum SCCA and CYFRA 21-1,
Tissue Ki-67, and Clinicopathological Factors in Patients
with Esophageal Squamous Cell Carcinoma
Somkiat Sunpaweravong MD*, Puttisak Puttawibul MD*, Patrapim Sunpaweravong MD**,
Anupong Nitiruangjaras MD***, Pleumjit Boonyaphiphat MSc***, Marisa Kemapanmanus MSc***
Affiliation :
* Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
** Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
*** Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Background : Squamous cell carcinoma antigen (SCCA) and CYFRA 21-1 have been reported as useful tumor markers for
esophageal squamous cell carcinoma (ESCC), but no information has yet been reported about the relationship between
these serum tumor markers and tissue proliferative activity (Ki-67) in ESCC patients.
Objective : To study the correlation between SCCA, CYFRA 21-1, Ki-67, and clinicopathological factors in ESCC patients.
Material and Method: Pretreatment SCCA and CYFRA 21-1 serum levels were measured, while the expression of Ki-67
was assessed on tumor tissue. The associations between these biomarkers, clinicopathological factors, and overall survival
were analyzed.
Results : One hundred sixty six patients participated in this study. Elevated SCCA and CYFRA 21-1 were found in 78.9% and
50.0% of the patients, respectively, while 42.8% had both serum markers elevated. The SCCA and CYFRA 21-1 levels were
not correlated (p = 0.128) to each other, nor to age, sex, T, N, M, location, grade, or Ki-67. High Ki-67 expression levels
were significantly correlated with T4 (p = 0.010), M1 (p = 0.010), and poor grade (p = 0.015) but not to age, sex, N, or
location. Levels of SCCA, CYFRA 21-1, and Ki-67, alone or in any combination, were not correlated to survival of patients.
Conclusion : The authors showed that Ki-67 in tumor tissue is probably a more reliable marker than serum SCCA and
CYFRA 21-1 in predicting the clinical course of ESCC.
Keywords : SCCA, CYFRA 21-1, Ki-67, Esophagus cancer, Squamous cell
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