Abstract
Distant metastasis hinders a favorable outcome for patients with esophageal squamous cell carcinoma (ESCC) by limiting the surgical cure. The levels of cell-free DNA (cfDNA) in the blood have served as a predictor for metastasis and recurrence in distant organs in liver cancer. Thus, this study tested the clinical efficacy of serum cfDNA levels as a predictive marker for distant metastasis of ESCC. We investigated cfDNA levels in a cohort of 101 ESCC patients and 46 age- and gender-matched control patients with benign disease. We found that serum cfDNA levels were significantly higher in the ESCC patients than in the control patients (P=0.034). In the ESCC patients, serum cfDNA levels were positively associated with tumor size and cytokeratin 19 fragment (CYFRA 21-1) expression (r=0.416 and r=0.573, respectively). An increase in cfDNA levels was also associated with host inflammation status including C-reactive protein levels and neutrophil and monocyte numbers in the peripheral blood. Serum cfDNA levels tended to be higher in advanced tumors when compared to early stage tumors. We found that serum cfDNA levels were significantly higher in ESCC patients with distant metastasis than in those without (P=0.011). Logistic regression analysis showed that serum cfDNA levels represented only one independent risk factor for distant metastasis among the five factors tested including gender, age, cfDNA levels, CYFRA 21-1 and squamous cell carcinoma antigen levels (P=0.0414). These results suggest that increased serum cfDNA levels may serve as a useful predictor for distant metastasis of ESCC.
Highlights
Esophageal squamous cell carcinoma (ESCC) is a predominant histological subtype of esophageal cancer
Distant metastasis hinders a favorable outcome in ESCC patients by limiting the surgical cure [7,8], and accounts for the poor 5-year survival rate of less than 20% worldwide [9,10]
In order to improve the poor prognosis for ESCC, it is essential to identify an easy-to-use marker for predicting metastasis and recurrence of ESCC in distant organs including the abdominal lymph node
Summary
Esophageal squamous cell carcinoma (ESCC) is a predominant histological subtype of esophageal cancer. ESCC is one of the most fatal malignancies, as progression occurs without symptoms and many tumors are significantly advanced by the time of diagnosis [2,3]. Despite recent advances in surgical techniques and therapy combined with chemotherapy or chemo-radiotherapy [4,5,6], many ESCC patients develop metastatic disease. Distant metastasis hinders a favorable outcome for patients with ESCC by limiting the surgical cure [7,8]. ESCC patient prognosis remains poor, with a 5-year survival rate of less than 20% worldwide [9,10]. In order to improve the poor prognosis of ESCC, it is essential to identify an easy-to-use marker for predicting the spread of ESCC cells into distant organs such as the lung and the abdominal lymph node
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have