Combination of c-reactive protein and squamous cell carcinoma antigen in predicting postoperative prognosis for patients with squamous cell carcinoma of the esophagus
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Ji-Feng Feng1,2, Sheng Chen1,2 and Xun Yang1,2
1Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China
2Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou 310022, China
Xun Yang, email: [email protected]
Keywords: esophageal squamous cell carcinoma (ESCC), c-reactive protein (CRP), squamous cell carcinoma antigen (SCC), cancer-specific survival (CSS), prognosis
Received: March 27, 2017 Accepted: May 08, 2017 Published: June 27, 2017
Background: We initially proposed a useful and novel prognostic model, named CCS [Combination of c-reactive protein (CRP) and squamous cell carcinoma antigen (SCC)], for predicting the postoperative survival in patients with esophageal squamous cell carcinoma (ESCC).
Methods: Two hundred and fifty-two patients with resectable ESCC were included in this retrospective study. A logistic regression was performed and yielded a logistic equation. The CCS was calculated by the combined CRP and SCC. The optimal cut-off value for CCS was evaluated by X-tile program. Univariate and multivariate analyses were used to evaluate the predictive factors. In addition, a novel nomogram model was also performed to predict the prognosis for patients with ESCC.
Results: In the current study, CCS was calculated as CRP+6.33 SCC according to the logistic equation. The optimal cut-off value was 15.8 for CCS according to the X-tile program. Kaplan-Meier analyses demonstrated that high CCS group had a significantly poor 5-year cancer-specific survival (CSS) than low CCS group (10.3% vs. 47.3%, P <0.001). According to multivariate analyses, CCS (P =0.004), but not CRP (P =0.466) or SCC (P =0.926), was an independent prognostic factor. A nomogram could be more accuracy for CSS (Harrell’s c-index: 0.70).
Conclusion: The CCS is a usefull and independent predictive factor in patients with ESCC.
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