Serum Markers as Predictors of Esophageal Squamous Dysplasia and Early Cancer

Abstract

Background: Squamous dysplasia is the precursor lesion for esophageal squamous cell carcinoma (ESCC). A primary screening test for ESCC which identified this lesion could lead to a reduction in disease-specific mortality. Materials and Methods: We conducted a population-based screening study in Linzhou, China. All subjects provided blood samples and underwent endoscopy with Lugol's iodine staining and biopsy. We selected a subset of 84 subjects stratified on worst squamous histologic diagnosis in six categories and measured the serum concentrations of potential markers using commercially available ELISA tests for matrix metalloprotease-9, tissue inhibitor of matrix metalloprotease-1, copper/zinc superoxide dismutase, anti-p53 auto-antibodies, and soluble serum interleukin-2 receptor. Results: Serum matrix metalloprotease-9 concentration was significantly different by esophageal squamous dysplasia status with a median (interquartile range) for subjects without dysplasia of 150 ng/ml (80-225) and subjects with dysplasia/early cancer of 97 ng/ml (58-155), p=0.033), but the maximum sensitivity and specificity were low. The serum concentrations of the other markers tested showed no significant differences by category of worst histologic diagnosis. Conclusion: Serum matrix metalloprotease-9 concentration could contribute to a primary screening test for an ESCC, but is insufficient alone.