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局部晚期食管鳞状细胞癌血清p53抗体的术后五年监测

Five-year postsurgical monitoring of serum p53 antibody for locally advanced esophageal squamous cell carcinoma.

作者信息

Kochi Ryosuke, Yajima Satoshi, Nanami Tatsuki, Suzuki Takashi, Oshima Yoko, Tokura Natsuki, Takatsuka Jun, Funahashi Kimihiko, Tochigi Naobumi, Shimada Hideaki

机构信息

Department of Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.

Department of Surgery, Sagamihara Chuo Hospital, 6-4-20 Fujimi, Chuo-ku, Sagamihara, 252-0236, Japan.

出版信息

Clin J Gastroenterol. 2018 Aug;11(4):278-281. doi: 10.1007/s12328-018-0839-3. Epub 2018 Mar 1.

Abstract

Serum p53 antibody (s-p53-Ab) titers were postoperatively monitored for over 5 years in a 67-year-old man with locally advanced esophageal squamous cell carcinoma. The tumor stage was classified as clinical stage II (cT3N0M0). Serum SCC antigen (s-SCC-Ag; 6.2 ng/mL) and s-p53-Ab (3.83 U/mL) were noted to be positive before surgery. Radical esophagectomy with three-field lymph node dissection was performed without neoadjuvant therapy. Pathological findings of the surgically resected specimens revealed a stage II tumor (pT3N0M0). Postoperatively, the patients did not receive any adjuvant therapy. Although the s-SCC-Ag was found to be negative at 2 months postoperatively, s-SCC-Ag was found to be six times positive despite no signs of recurrence. The s-p53-Ab titers constantly decreased to less than the cutoff value at 6 months postoperatively and continuously decreased over 5 years postoperatively. Finally, s-p53-Ab titers became less than the detection limit value at 60 months postoperatively. No recurrence was observed throughout the postoperative course. This case report is the first to describe the five-year monitoring of postoperative changes in s-p53-Ab titers in a patient with locally advanced esophageal squamous cell carcinoma without recurrence. s-p53-Ab titers seemed to be more useful than s-SCC-Ag for disease monitoring in this case.

摘要

对一名67岁局部晚期食管鳞状细胞癌男性患者术后5年多来的血清p53抗体(s-p53-Ab)滴度进行了监测。肿瘤分期为临床II期(cT3N0M0)。术前血清鳞状细胞癌抗原(s-SCC-Ag;6.2 ng/mL)和s-p53-Ab(3.83 U/mL)呈阳性。在未进行新辅助治疗的情况下,实施了根治性食管切除术及三野淋巴结清扫术。手术切除标本的病理检查结果显示为II期肿瘤(pT3N0M0)。术后,患者未接受任何辅助治疗。尽管术后2个月时s-SCC-Ag呈阴性,但在无复发迹象的情况下,s-SCC-Ag六次呈阳性。s-p53-Ab滴度在术后6个月时持续降至临界值以下,并在术后5年持续下降。最终,s-p53-Ab滴度在术后60个月时降至检测极限值以下。术后整个病程均未观察到复发。本病例报告首次描述了局部晚期食管鳞状细胞癌患者术后s-p53-Ab滴度变化的五年监测情况,且无复发。在该病例中,s-p53-Ab滴度在疾病监测方面似乎比s-SCC-Ag更有用。

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