Division of Digestive Endoscopy, Shiga University of Medical Science, Japan.
Division of Gastroenterology, Department of Medicine, Shiga University of Medical Science, Japan.
Intern Med. 2024 Dec 1;63(23):3179-3183. doi: 10.2169/internalmedicine.3300-23. Epub 2024 Apr 2.
Cytokeratin (CK) is a specific marker of adenocarcinoma. However, cases of CK7-positive esophageal squamous cell carcinoma (ESCC) have only rarely been reported. We herein report a case of unresectable CK7-positive ESCC with aggressive liver metastasis following nivolumab treatment initiation. Nivolumab treatment was discontinued after one course because of complications. Notably, the liver metastases exhibited accelerated growth. Immunostaining of the necropsy specimens revealed diffuse positivity for forkhead box protein A1 (FOXA1)/CK7, thus indicating a potent poor immune response. The potential correlation between CK7 expression and the immune checkpoint inhibitor response may offer valuable insights into the development of effective therapeutic strategies.
细胞角蛋白（CK）是腺癌的特异性标志物。然而，CK7 阳性的食管鳞状细胞癌（ESCC）病例很少有报道。本文报告了一例不可切除的 CK7 阳性 ESCC 病例，在接受纳武利尤单抗治疗后出现侵袭性肝转移。由于并发症，纳武利尤单抗治疗在一个疗程后被停止。值得注意的是，肝转移灶的生长速度加快。尸检标本的免疫组化染色显示叉头框蛋白 A1（FOXA1）/CK7 弥漫阳性，表明免疫反应较弱。CK7 表达与免疫检查点抑制剂反应之间的潜在相关性可能为开发有效的治疗策略提供有价值的见解。
