Clinical Value of Serum p53 Antibody in the Diagnosis and Prognosis of Esophageal Squamous Cell Carcinoma
Clinical Value of Serum p53 Antibody in the Diagnosis and Prognosis of Esophageal Squamous Cell Carcinoma
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DOI：
10.21873/anticanres.12419
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发表时间：
2018-03-01
影响因子：
2
通讯作者：
Nagayasu, Takeshi
中科院分区：
文献类型：
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作者：
Kunizaki, Masaki;Hamasaki, Keiko;Nagayasu, Takeshi
背景/目的：识别有用的生物标志物是选择最佳食管鳞状细胞癌治疗策略的关键。检测血清P53抗体(S-p53Ab)、鳞癌抗原(SCC-Ag)、癌胚抗原(CEA)，评价单项及联合指标对食管癌的诊断及预后判断的意义。材料和方法：收集133例经手术病理证实的食管鳞癌患者的血清标本，其中I期32例(24.1%)。采用新型高特异性定量试剂盒，用酶联免疫吸附试验检测S-p53Ab水平。结果：39.1%(52/133)的鳞癌患者血清中存在S-p53Ab，其中40.0%(20/50)的早期鳞癌患者血清中存在S-p53抗体。在32例I期食管鳞癌患者中，S-p53抗体、癌胚抗原和鳞癌抗原的阳性率分别为40.6%、12.5%和31.3%。S-p53抗体阳性与CEA、SCCAg阳性无相关性(P分别为0.249和0.747)。Sp53Ab联合SCC-Ag诊断食管鳞癌的阳性率由39.1%提高到65.4%。我们发现食管鳞癌组织中S-p53Ab的表达与总生存期无明显相关性。COX回归分析显示，国际抗癌联合会分级和全身炎症评分是食管鳞癌的独立预后因素(危险性比(HR)=3.811，95%可信区间(CI)=1.548~9.378，p=0.004；HR=2.218，95%CI=1.087~4.523，p=0.029)。Kaplan-Meier分析显示，S-p53抗体和鳞癌抗原升高的患者与仅有一项或两项均未升高的患者之间有显著差异(p=0.009)。结论：S-p53Ab对早期食管癌的诊断率高于鳞癌抗原和癌胚抗原。联合检测S-p53抗体和鳞癌抗原可显著提高诊断的敏感性，并可对食管癌患者进行更准确的分层。
Background/Aim: Identifying useful biomarkers is central to selecting optimal therapeutic strategies for esophageal squamous cell carcinoma (ESCC). Serum p53 antibody (S-p53Ab), squamous cell carcinoma antigen (SCC-Ag), and carcinoembryonic antigen (CEA) were investigated to evaluate the significance of single and combined tumor markers in determining the diagnosis and prognosis of ESCC. Materials and Methods: Serum samples were obtained preoperatively from 133 patients with histologically-confirmed ESCC, including 32 patients with stage I (24.1%). Levels of S-p53Ab were assessed by enzyme-linked immunosorbent assay, using a new version of a highly specific, quantitative kit. The cut-off value for S-p53Ab was 1.3 U/ml. Results: S-p53Ab was detected in 39.1% (52 out of 133) of patients with ESCC, including 40.0% (20 out of 50) of patients with early-stage ESCC. Positive rates for S-p53Ab, CEA, and SCC-Ag among patients with stage I ESCC (n=32) were 40.6%, 12.5%, and 31.3%, respectively. Positivity for S-p53Ab was not associated with positivity for CEA or SCCAg (p=0.249 and 0.747, respectively). The positive rate for diagnosis of ESCC increased from 39.1% to 65.4% when Sp53Ab was combined with SCC-Ag in this study. We found no significant correlation between the presence of S-p53Ab in ESCC and overall survival. Conversely, Cox regression analysis revealed that the International Union Against Cancer/TNM classification and systemic inflammation score were independent prognostic factors for ESCC in this series (hazard ratio(HR)=3.811, 95% confidence interval(CI)=1.548-9.378, p=0.004; and HR=2.218; 95% CI=1.087-4.523, p=0.029, respectively). Kaplan-Meier analysis revealed significant differences between patients with elevated S-p53Ab and SCC-Ag and patients with elevated levels of only one or neither of these factors (p=0.009). Conclusion: The diagnostic rate with S-p53Ab was better than that with SCC-Ag and CEA in patients with early-stage ESCC. Combined detection of S-p53Ab and SCC-Ag can markedly improve diagnostic sensitivity and may permit more accurate stratification of patients with ESCC.