Shimada H, Takeda A, Arima M, Okazumi S, Matsubara H, Nabeya Y, Funami Y, Hayashi H, Gunji Y, Suzuki T, Kobayashi S, Ochiai T
Department of Surgery, Chiba University School of Medicine, Chiba, Japan.
Cancer. 2000 Oct 15;89(8):1677-83.
Patients with superficial (mucosal or submucosal) esophageal carcinoma (SEC) have significantly better survival rates than patients with advanced carcinoma. Some patients with advanced esophageal carcinoma have been reported to test positive for serum p53 antibodies (Abs). Because very few patients with superficial carcinoma have been examined, the aim of this study was to evaluate the clinical significance of serum p53-Abs in patients with superficial esophageal squamous cell carcinoma (SESCC).
Thirty-five consecutive patients with SESCC were studied for serum p53-Abs by enzyme-linked immunoabsorbent assay before and after treatment. The clinicopathologic features of p53 seropositive and p53 negative patients were compared. The relation between the presence of serum p53-Abs and p53 immunoreactivity of the resected specimens was examined. Three tumor markers (squamous cell carcinoma antigen [SCC-Ag], CYFRA21-1, and carcinoembryonic antigen [CEA]) were assessed to compare their sensitivities with serum p53-Abs.
Fourteen of 35 patients (40%) were p53 seropositive. Relatively few patients tested positive for the other tumor markers: CEA, 11.4%; SCC-Ag, 14.3%; CYFRA21-1, 5.7%. There were no significant correlations between clinicopathologic features and p53 seropositivity except for tumor location. A strong correlation between p53 immunostaining and the presence of serum p53-Abs was observed (P = 0.003). Of the 14 patients with seropositive results, 12 turned seronegative after resection, and the other 2 experienced disease recurrence.
Surveillance of serum p53-Abs is superior to the three tumor markers for detecting SESCC. This serum marker is also useful for the detection of p53 protein overexpression and for the monitoring of residual tumor cells.
浅表性（黏膜或黏膜下）食管癌（SEC）患者的生存率明显高于进展期癌患者。据报道，一些进展期食管癌患者血清p53抗体（Abs）检测呈阳性。由于接受检测的浅表性癌患者极少，本研究旨在评估血清p53-Abs在浅表性食管鳞状细胞癌（SESCC）患者中的临床意义。
对35例连续性SESCC患者在治疗前后采用酶联免疫吸附测定法检测血清p53-Abs。比较p53血清阳性和阴性患者的临床病理特征。检测血清p53-Abs的存在与切除标本中p53免疫反应性之间的关系。评估三种肿瘤标志物（鳞状细胞癌抗原[SCC-Ag]、细胞角蛋白19片段[CYFRA21-1]和癌胚抗原[CEA]），以比较它们与血清p53-Abs的敏感性。
35例患者中有14例（40%）p53血清阳性。其他肿瘤标志物检测呈阳性的患者相对较少：CEA为11.4%；SCC-Ag为14.3%；CYFRA21-1为5.7%。除肿瘤位置外，临床病理特征与p53血清阳性之间无显著相关性。观察到p53免疫染色与血清p53-Abs的存在之间存在强相关性（P = 0.003）。在14例血清阳性结果的患者中，12例切除后转为血清阴性，另外2例出现疾病复发。
监测血清p53-Abs在检测SESCC方面优于三种肿瘤标志物。这种血清标志物也有助于检测p53蛋白过表达和监测残留肿瘤细胞。
