Prognostic Value of Preoperative Serum CA 242 in Esophageal Squamous Cell Carcinoma Cases

  • Feng, Ji-Feng (Department of Thoracic Surgery, Zhejiang Cancer Hospital) ;
  • Huang, Ying (Department of Operating Theatre, Zhejiang Cancer Hospital) ;
  • Chen, Qi-Xun (Department of Thoracic Surgery, Zhejiang Cancer Hospital)
  • Published : 2013.03.30


Purpose: Carbohydrate antigen (CA) 242 is inversely related to prognosis in many cancers. However, few data regarding CA 242 in esophageal cancer (EC) are available. The aim of this study was to determine the prognostic value of CA 242 and propose an optimum cut-off point in predicting survival difference in patients with 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 cuf-off point. 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 optimum cut-off of 2.15 (U/ml). Patients with CA 242 ${\leq}$ 2.15 U/ml had significantly better 5-year survival than patients with CA 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.


  1. Bunger S, Laubert T, Roblick UJ, et al (2011). Serum biomarkers for improved diagnostic of pancreatic cancer: a current overview. J Cancer Res Clin Oncol, 137, 375-89.
  2. Chen W, Abnet CC, Wei WQ, et al (2004). Serum markers as predictors of esophageal squamous dysplasia and early cancer. Anticancer Res, 24, 3245-9.
  3. Ferguson MK, Martin TR, Reeder LB, et al (1997). Mortality after esophagectomy: risk factor analysis. World J Surg, 2, 599-603.
  4. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-7.
  5. Jiang H, Wang XH, Yu XM, et al (2012). Detection and prognostic analysis of serum protein expression in esophageal squamous cell cancer. Asian Pac J Cancer Prev, 13, 1579-82.
  6. Kunisaka C, Makino I, Kimura J, et al (2010). Impact of lymphnode metastasis site in patients with thoracic esophageal cancer. J Surg Oncol, 101, 36-42.
  7. Kuusela P, Haglund C, Roberts PJ (1991). Comparison of a new tumour marker CA 242 with CA 19-9, CA 50 and carcinoembryonic antigen (CEA) in digestive tract diseases. Br J Cancer, 63, 636-40.
  8. Lerut TE, de Leyn P, Coosemans W, et al (1994). Advanced esophageal carcinoma. World J Surg, 18, 379-87.
  9. Mao WM, Zheng WH, Ling ZQ (2011). Epidemiologic risk factors for esophageal cancer development. Asian Pac J Cancer Prev, 12, 2461-6.
  10. Mirinezhad SK, Somi MH, Jangjoo AG, et al (2012). Survival rate and prognostic factors of esophageal cancer in east Azerbaijan province, North-west of Iran. Asian Pac J Cancer Prev, 13, 3451-4.
  11. Rana S, Dutta U, Kochhar R, et al (2012). Evaluation of CA 242 as a tumor marker in gallbladder cancer. J Gastrointest Cancer, 43, 267-71.
  12. Rice TW, Rusch VW, Ishwaran H, et al (2010). Cancer of the esophagus and esophagogastric junction: data-driven staging for the seventh edition of the American Joint Committee on Cancer/International Union Against Cancer Staging Manuals. Cancer, 116, 3763-73.
  13. Vallbohmer D, Lenz HJ (2006). Predictive and prognostic molecular markers in outcome of esophageal cancer. Dis Esophagus, 19, 425-32.

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