Kochi Ryosuke, Yajima Satoshi, Nanami Tatsuki, Suzuki Takashi, Oshima Yoko, Tokura Natsuki, Takatsuka Jun, Funahashi Kimihiko, Tochigi Naobumi, Shimada Hideaki
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.
Clin J Gastroenterol. 2018 Aug;11(4):278-281. doi: 10.1007/s12328-018-0839-3. Epub 2018 Mar 1.
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.
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。