Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4572
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
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.
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.
This is a frontal report of SCCA overexpression in poorly differentiated adenocarcinoma of the stomach.
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.