Prognostic Value of Preoperative Serum CA 242 in EsophagealSquamous Cell Carcinoma Cases

Purpose: Carbohydrate antigen (CA) 242 is inversely related to prognosis in many cancers. However, fewdata regarding CA 242 in esophageal cancer (EC) are available. The aim of this study was to determine theprognostic value of CA 242 and propose an optimum cut-off point in predicting survival difference in patientswith esophageal squamous cell carcinoma (ESCC).
Methods: A retrospective analysis was conducted of 192 cases.A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimum cufoffpoint. Univariate and multivariate analyses were performed to evaluate prognostic parameters for survival.
Results: The positive rate for CA 242 was 7.3% (14/192). The ROC curve for survival prediction gave an optimumcut-off of 2.15 (U/ml). Patients with CA 242 ≤ 2.15 U/ml had significantly better 5-year survival than patients withCA 242 >2.15 U/ml (45.4% versus 22.6%; P=0.003). Multivariate analysis showed that differentiation (P=0.033),CA 242 (P=0.017), T grade (P=0.004) and N staging (P<0.001) were independent prognostic factors.
Conclusions:Preoperative CA 242 is a predictive factor for long-term survival in ESCC, especially in nodal-negative patients.We conclude that 2.15 U/ml may be the optimum cuf-off point for CA 242 in predicting survival in ESCC.