Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4572-4578
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4572
High expression of squamous cell carcinoma antigen in poorly differentiated adenocarcinoma of the stomach: A case report
Lin Wang, Lei Huang, Lei Xi, Shi-Chang Zhang, Jie-Xin Zhang
Lin Wang, Shi-Chang Zhang, Jie-Xin Zhang, Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Lei Huang, Department of Laboratory Medicine, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Lei Xi, Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Wang L and Huang L collected the information of the patient and wrote the manuscript; Zhang JX and Zhang SC designed the study and revised the manuscript; Xi L performed immunohistochemistry; all authors issued final approval for the version to be submitted.
Supported by The Six Top Talent Project of Jiangsu Province, No. WSW-004; National Natural Science Foundation of China, No. 81671836; and Key Laboratory for Laboratory Medicine of Jiangsu Province of China, No. ZDXKB2016005.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jie-Xin Zhang, MD, PhD, Senior Researcher, Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. jiexinzhang@njmu.edu.cn
Received: May 22, 2020
Peer-review started: May 22, 2020
First decision: July 29, 2020
Revised: August 11, 2020
Accepted: September 5, 2020
Article in press: September 5, 2020
Published online: October 6, 2020
Abstract
BACKGROUND

Squamous cell carcinoma antigen (SCCA) is regarded as a specific indicator of epithelial malignancies and is widely used in the diagnosis of squamous cell carcinoma (SCC). However, the expression of SCCA in gastric adenocarcinoma has not been studied in detail.

CASE SUMMARY

A 52-year-old man was admitted to our hospital for a 2.5 cm × 2.5 cm ulcer at the antrum-body junction with dull pain and fullness in the upper abdomen for 2 mo. His pre-surgery serological testing results showed 0.51 ng/mL SCCA (reference interval, < 1.5 ng/mL) and 9.9 ng/mL carcinoembryonic antigen (reference range, < 4.7 ng/mL). He underwent radical distal gastrectomy and Roux-en Y anastomosis and was diagnosed with poorly differentiated mucinous adenocarcinoma (Lauren classification: Diffuse) by pathological examination of the resected lesion. Immunohistochemistry showed that SCCA was highly expressed in the cytoplasm of cancer cells. After surgery, the patient received an S-1 adjuvant chemotherapy regimen for six cycles containing tegafur, gimeracil, and oteracil potassium. He showed no sign of recurrence or metastasis within 24-mo follow-up.

CONCLUSION

This is a frontal report of SCCA overexpression in poorly differentiated adenocarcinoma of the stomach.

Keywords: Squamous cell carcinoma antigen, Gastric adenocarcinoma, Protease inhibitor, Immunohistochemical staining, Differentiation, Case report

Core Tip: We report a typical case of poorly differentiated mucinous adenocarcinoma (pT3aN3aM0) with squamous cell carcinoma antigen (SCCA) overexpression. Since the patient had no sign of recurrence or metastasis up to 24 mo, it might contribute to improving the understanding of the nature of SCCA as a protease inhibitor in cancer. This report also emphasizes a subgroup of patients who have been diagnosed with adenocarcinoma and serves as a reminder to oncologists that a prospective cohort study should be carried out to evaluate SCCA-related prognosis.