Elsevier

Surgery

Volume 132, Issue 1, July 2002, Pages 41-47
Surgery

Papers from the Japanese Surgical Society
Prognostic significance of serum p53 antibody in patients with esophageal squamous cell carcinoma*,☆☆

Presented at the 63rd Annual Meeting of the Society of University Surgeons, Honolulu, Hawaii, February 14-16, 2002.
https://doi.org/10.1067/msy.2002.125307Get rights and content

Abstract

Background. The p53 protein overexpression that usually results from genetic alterations has been reported to induce serum antibodies against p53. There is little information about the clinicopathologic and prognostic significance of preoperative serum p53 antibody in patients with esophageal cancer. Methods. A highly specific enzyme-linked immunosorbent assay was used to analyze serum p53 antibodies in 105 patients with esophageal squamous cell carcinoma. The cutoff level of 1.3 U/mL was used to indicate seropositive patients, and the cutoff level of 10 U/mL was used to identify high titer patients. At 3 months after surgery, seropositive patients were examined again. Results. A total of 28 patients (26.7%) were positive for serum p53 antibodies. The patients who remained seropositive were more likely to develop tumor recurrence (P =.025). Seropositive patients had worse outcome than seronegative patients. The high titer group had significant association with advanced tumor stages and worse outcomes than the low titer group. High serum p53 antibody titer was an independent prognostic factor (P <.001). Conclusions. We found that serum p53 antibody was useful to detect esophageal cancer and to identify those with a high risk of tumor recurrence and a poor prognosis. (Surgery 2002;132:41-7.)

Section snippets

Patients

A total of 105 consecutive patients with primary esophageal squamous cell carcinoma were enrolled in this study. Patients included 92 men (88%) and 13 women (12%) with a median age of 65 years (range, 40 to 87 years). They were surgically treated at Chiba University Hospital between April 1997 and December 2000. TNM classification13 was established on the basis of pathologic examinations of resected specimens. Among 105 patients, 50 patients had stage I disease, 24 had stage II, 21 had stage

Titer of serum p53-Ab and conventional tumor markers in patients with esophageal squamous cell carcinoma

Serum p53-Ab levels in 105 patients with primary esophageal squamous cell carcinoma were significantly higher than those in healthy control subjects (median 0.35 U/mL, range 0 to 168 U/mL vs median 0.20 U/mL, range 0 to 2.6 U/mL, P <.001). On the basis of comparison to the 95% range of distribution of serum p53-Ab titers in healthy control subjects, a cutoff value was determined as 1.3 U/mL. Thus, 28 of the 105 (26.7%) patients were positive for serum p53-Abs. The positivity rate for patients

Discussion

Tumor markers are supportive for establishing diagnosis, estimating prognosis, monitoring treatment, detecting recurrence, and screening. In comparison to other malignancies of the gastrointestinal tract, there are few suitable biomarkers for esophageal squamous cell carcinoma.14, 15

We investigated the clinicopathologic significance of serum p53-Abs in patients with esophageal cancer. In this study, positivity rate for detecting esophageal cancer was 27% for patients overall and 20% for

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  • *

    Supported in part by a Grant-in-Aid from the Ministry of Education, Science and Culture of Japan (Advanced Medicine Development Project and #12671200).

    ☆☆

    Reprint requests: Hideaki Shimada, MD, Department of Academic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana Chuou-ku, Chiba 260-8677, Japan.

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