Seto Nayuta, Miura Kouichi, Jin Ling, Nakahara Moriyasu
Department of Internal Medicine, Chichibu Municipal Hospital, Saitama, JPN.
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, JPN.
Cureus. 2024 Apr 2;16(4):e57477. doi: 10.7759/cureus.57477. eCollection 2024 Apr.
We report an autopsy case of advanced esophageal cancer with multiple metastases that presented with a markedly high level of sIL-2R. An 83-year-old man was admitted to our hospital with a 1-week history of epigastric distress, appetite loss, and fatigue. Imaging examinations revealed a large liver tumor. Although the tumor markers for gastrointestinal and liver cancers were within normal limits, the sIL-2R level was extremely high (10,384 U/mL). The patient died immediately after admission due to the rapid course of the disease. An autopsy showed advanced esophageal cancer with multiple metastases, including the liver, lungs, and multiple lymph nodes. In histological examinations, esophageal cancer was a mixture of well- and poorly differentiated squamous cell carcinoma, in which poorly differentiated cancer cells expressed sIL-2R on immunohistochemical staining. However, we failed to detect positive staining for sIL-2R in the lymphocytes. Our findings revealed that solid tumors could express sIL-2R. Although sIL-2R is a tumor marker used for hematological malignancies, such as malignant lymphoma, this case report highlights the value of the measurement of sIL-2R levels in advanced solid tumors, including esophageal cancer. We concluded that sIL-2R has potential as a biomarker in advanced solid tumors for cancer staging and treatment response.
我们报告一例伴有多处转移的晚期食管癌尸检病例,该病例呈现出显著高水平的可溶性白细胞介素-2受体(sIL-2R)。一名83岁男性因上腹部不适、食欲减退和疲劳1周入住我院。影像学检查发现肝脏有一个大肿瘤。尽管胃肠道和肝癌的肿瘤标志物在正常范围内,但sIL-2R水平极高(10384 U/mL)。患者入院后因病情进展迅速立即死亡。尸检显示为晚期食管癌,伴有多处转移,包括肝脏、肺和多处淋巴结。组织学检查显示,食管癌是高分化和低分化鳞状细胞癌的混合体,其中低分化癌细胞在免疫组化染色中表达sIL-2R。然而,我们未能在淋巴细胞中检测到sIL-2R的阳性染色。我们的研究结果表明实体瘤可以表达sIL-2R。尽管sIL-2R是用于血液系统恶性肿瘤(如恶性淋巴瘤)的肿瘤标志物,但本病例报告强调了在包括食管癌在内的晚期实体瘤中检测sIL-2R水平的价值。我们得出结论,sIL-2R有潜力作为晚期实体瘤癌症分期和治疗反应的生物标志物。