Carbohydrate antigens as a risk factor for hematogenous recurrence of esophageal squamous cell carcinoma patients

The patients with hematogenous recurrence have a poor prognosis in esophageal squamous cell carcinoma (SCC). Recent developments have suggested the important role of sialyl Lewis A and X in the step of hematogenous metastasis. To evaluate the role of two carbohydrate antigens on hematogenous recurrence in esophageal SCC, we examined clinicopathological features and the expression of sialyl Lewis A and X in 125 patients retrospectively. Thirty-three out of 125 patients had hematogenous recurrence after curative esophagectomy. sLeA and sLex expression correlated with hematogenous recurrence (p=0.026, p=0.043 respectively), and sLeA expression was correlated with pM (lymph). Cox proportional hazards model and logistic regression analysis revealed that pN and pM lymph were significant prognostic factors and predictive factors of hematogenous recurrence in esophageal SCC. Although, neither sLeA nor sLeX were significant factors affecting survival in esophageal SCC, logistic regression analysis demonstrated that increased tumoral expression of sLeA and sLeX were risk factors of hematogenous recurrence in esophageal SCC. In conclusion, patients with lymph node metastasis, in particular those with distant lymph node metastasis, the expression of sLeA and sLeX may suggest a higher incidence of hematogenous recurrence in esophageal SCC. New strategies for specific inhibition of cancer cell attachment to vascular endothelial cells should be considered for the patients with the increased tumoral expression of either sLeA or sLeX.