Perioperative Changes of Serum p53 Antibody Titer is a Predictor for Survival in Patients with Esophageal Squamous Cell Carcinoma
Perioperative Changes of Serum p53 Antibody Titer is a Predictor for Survival in Patients with Esophageal Squamous Cell Carcinoma
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DOI：
10.1007/s00268-008-9821-4
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发表时间：
2009-02-01
影响因子：
2.6
通讯作者：
Ochiai, Takenori
中科院分区：
文献类型：
--
作者：
Shimada, Hideaki;Shiratori, Tooru;Ochiai, Takenori
研究背景虽然食管癌患者治疗前血清中存在p53抗体（s-p53-Abs）与预后不良及淋巴结转移相关，但关于食管癌患者术后s-p53-Abs滴度及围手术期s-p53-Abs滴度变化的资料很少。方法采用高特异性酶联免疫吸附法对110例食管鳞状细胞癌患者手术前后1个月的s-p53抗体进行检测。以1.3 U/ml的临界值为血清阳性。评估术后s-p53-Abs滴度及围手术期s-p53-Abs变化对生存率的影响。结果110例患者术前s-p53-Abs阳性40例（36%），术后阳性35例（32%）。术后s-p53-Abs滴度普遍降低。在血清阳性患者中，术后血清仍呈阳性的患者（n = 28）预后较血清转化患者差（P = 0.02）。血清阳性患者中，未降低滴度组生存期明显不利（P < 0.01）。多因素分析显示，术后s-p53-Abs是总生存差的独立危险因素（校正风险比= 3.05；95%可信区间= 1.11-8.33;P = 0.03）。结论围手术期监测s-p53-Abs抗体滴度有助于鉴别复发风险高、预后差的食管癌患者。即使在手术后，持续血清阳性患者和/或滴度未降低组也显示出明显不利的生存。
Background Although the presence of serum p53 antibody (s-p53-Abs) before treatment has been shown to correlate with poor prognosis and lymph node metastasis in esophageal cancer, there has been little information about postoperative s-p53-Abs titer and perioperative changes of s-p53-Abs titers in patients with esophageal carcinoma.Methods A highly specific enzyme-linked immunosorbent assay was used to analyze s-p53-Abs in 110 patients with esophageal squamous cell carcinoma before and 1 month after surgery. The cutoff level of 1.3 U/ml was used to indicate seropositive patients. Impact of postoperative s-p53-Abs titer and perioperative changes of s-p53-Abs on survival was evaluated.Results Forty (36%) of 110 patients were positive for s-p53-Abs before surgery and 35 patients (32%) were positive after surgery. s-p53-Abs titer generally decreased after surgery. Among sero-positive patients, the patients who remained sero-positive after surgery (n = 28) had a worse prognosis than patients who showed sero-conversion (P = 0.02). Among sero-positive patients, the nondecreased titer group showed significantly unfavorable survival (P < 0.01). Multivariate analysis revealed that postoperative s-p53-Abs was an independent risk factor for worse overall survival (adjusted hazard ratio = 3.05; 95% confidence interval = 1.11-8.33; P = 0.03).Conclusions Perioperative monitoring of s-p53-Abs titers was useful to identify patients with esophageal cancer with a high risk for tumor recurrence and a poor prognosis. Continuous sero-positive patients and/or nondecreased titer group, even after surgery, showed significantly unfavorable survival.