Elevated levels of serum amyloid A indicate poor prognosis in patients with esophageal squamous cell carcinoma

Abstract

BackgroundIncrease of Serum amyloid A (SAA) level has been observed in patients with a variety of cancers. The objective of this study was to determined whether SAA level could be used as a prognostic parameter in patients with esophageal squamous cell carcinoma (ESCC).MethodsSAA levels were measured by rate nephelometry immunoassay in 167 healthy controls and 167 ESCC patients prior to surgical resection. Statistical associations between clinicopathological observations and SAA levels were determined using the Mann–Whitney U test. The clinical value of SAA level as a prognostic parameter was evaluated using the Cox’s proportional hazards model.ResultsSAA levels were significantly higher in patients with ESCC compared to levels in healthy controls (13.88 ± 15.19 mg/L vs. 2.26 ± 1.66 mg/L, P < 0.001). Elevation of SAA levels (≥ 8.0 mg/L) was observed in 54.5% (91/167) of patients with ESCC but not in healthy controls. SAA levels were associated with tumor size (P < 0.001), histological differentiation (P = 0.015), T classification (P < 0.001), clinical stage (P < 0.001), lymph node metastasis (P < 0.001) and distant metastasis (P < 0.001), but not with the age and gender of the patients or tumor location. Multivariate analysis revealed that patients with an elevated level of SAA (≥ 8.0 mg/L) had significantly lower 5-year survival rate than those with non-elevated SAA (< 8.0 mg/L, log-rank P < 0.0001).ConclusionsAn elevated level of preoperative SAA was found to associate with tumor progression and poor survival in patients with ESCC.

Association between serum amyloid A levels and cancers: a systematic review and meta-analysis

“…Subsequently, the meta-analysis was carried out in different cancer stages. The result revealed that the average levels of SAA increased with the aggravation of cancer stages, which were in line with studies of Zhang et al ,14 Wang et al ,16 Autelitano et al ,20 Cocco et al ,21 Kanoh et al ,23 Chan et al 27 and Wang et al 30 …”

“…The result of meta-analysis of 20 studies with 3682 patients and 2424 healthy individuals were consistent with the findings of Zhang et al ,14 Cho et al ,15 Wang et al ,16 Autelitano et al ,20 Cocco et al ,21 Wang et al 30 and Edgell et al ,31 showing the strong relationship between SAA levels and cancers. Furthermore, these findings indicated that high SAA levels were certainly correlated with the occurrence and development of cancers.…”

“…There were 14 articles with high methodological quality, including the studies of Zhang et al ,14 Cho et al ,15 Wang et al ,16 Toriola et al ,19 Autelitano et al ,20 Cocco et al ,21 Wood et al ,22 Kanoh et al ,23 Benson et al ,24 Kimura et al ,25 Khan et al ,26 Chan et al ,27 Dai et al 28 and Liu et al 29. The studies of Cocco et al ,13 Wang et al ,30 Edgell et al ,31 Kim et al ,32 Sung et al 33 and Biran et al 34 had low methodological quality.…”

A Review of the Application of Inflammatory Biomarkers in Epidemiologic Cancer Research

“…SAA is related to stage of disease (159) and strongly associated with reduced long-term survival of BC (160), LC (161) and esophageal squamous cell carcinoma (162). SAA may represent a link between inflammation and metastasis, thereby reducing survival outcomes in CRC (163).…”

Phase I Study of Pazopanib and Ixabepilone in Patients With Solid Tumors

“…Serum amyloid A is an acute phase reactant that can be used as a prognostic biomarker for several solid tumors. 17 Upregulation of E-selectin in the hepatic sinusoidal vessels has been implicated for organ selectivity and propagation of metastases in colon cancer. [18][19][20][21] High presurgical serum levels of sE-selectin correlate with increased recurrence and poor survival in colon cancer.…”