title: Perioperative changes of serum p53 antibody titer is a predictor for survival in patients with esophageal squamous cell carcinoma.
abstract: BACKGROUND
  Although the presence of serum p53 antibody (s-p53-Abs) before treatment has been shown to correlate with poor prognosis and lymph node metastasis in esophageal cancer, there has been little information about postoperative s-p53-Abs titer and perioperative changes of s-p53-Abs titers in patients with esophageal carcinoma.
  
  
  METHODS
  A highly specific enzyme-linked immunosorbent assay was used to analyze s-p53-Abs in 110 patients with esophageal squamous cell carcinoma before and 1 month after surgery. The cutoff level of 1.3 U/ml was used to indicate seropositive patients. Impact of postoperative s-p53-Abs titer and perioperative changes of s-p53-Abs on survival was evaluated.
  
  
  RESULTS
  Forty (36%) of 110 patients were positive for s-p53-Abs before surgery and 35 patients (32%) were positive after surgery. s-p53-Abs titer generally decreased after surgery. Among sero-positive patients, the patients who remained sero-positive after surgery (n = 28) had a worse prognosis than patients who showed sero-conversion (P = 0.02). Among sero-positive patients, the nondecreased titer group showed significantly unfavorable survival (P < 0.01). Multivariate analysis revealed that postoperative s-p53-Abs was an independent risk factor for worse overall survival (adjusted hazard ratio = 3.05; 95% confidence interval = 1.11-8.33; P = 0.03).
  
  
  CONCLUSIONS
  Perioperative monitoring of s-p53-Abs titers was useful to identify patients with esophageal cancer with a high risk for tumor recurrence and a poor prognosis. Continuous sero-positive patients and/or nondecreased titer group, even after surgery, showed significantly unfavorable survival.
authors.affiliation: Department of Gastroenterological Surgery, Chiba Cancer Center, 666-2 Nitona-cho, Chuou-ku, Chiba, 260-8717, Japan. hshimada@chiba-cc.jp
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimada
authors.forename: Tooru
authors.initials: T
authors.lastname: Shiratori
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeda
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsushita
authors.forename: Shinichi
authors.initials: S
authors.lastname: Okazumi
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Akutsu
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
authors.forename: Fumio
authors.initials: F
authors.lastname: Nomura
authors.forename: Takenori
authors.initials: T
authors.lastname: Ochiai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000912:Antibodies, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000401:mortality / Q000601:surgery*; D004797:Enzyme-Linked Immunosorbent Assay; D004938:Esophageal Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000097:blood*
chemical_list: D000912:Antibodies, Neoplasm; D014408:Biomarkers, Tumor; D016159:Tumor Suppressor Protein p53