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Prognostic significance of serum p53 antibody according to KRAS status in metastatic colorectal cancer patients.

转移性结直肠癌患者血清 p53 抗体根据 KRAS 状态的预后意义。

  • 影响因子:2.49
  • DOI:10.1007/s10147-019-01599-4
  • 作者列表:"Daitoku N","Miyamoto Y","Sakamoto Y","Tokunaga R","Hiyoshi Y","Nagai Y","Iwatsuki M","Iwagami S","Yoshida N","Baba H
  • 发表时间:2020-04-01
Abstract

BACKGROUND:Serum anti-p53 antibody is used clinically as a tumor marker of colorectal cancer. However, its prognostic significance in patients with metastatic colorectal cancer (mCRC) remains unclear. KRAS status may influence the host immune response against tumor progression. In the present study, we investigated the prognostic significance of serum anti-p53 in mCRC patients with wild-type KRAS and mutant KRAS treated with systemic chemotherapy. METHODS:A retrospective study of 150 mCRC patients in whom serum anti-p53 antibody was measured before first-line chemotherapy was conducted. The patients were divided into two groups, high p53 and low p53, based on their serum anti-p53 antibody levels. Associations between serum anti-p53 level and clinical outcomes were evaluated in conjunction with KRAS status. RESULTS:There were 97 (64.7%) patients with wild-type KRAS and 53 (35.3%) with mutant KRAS. In an analysis of all patients, there was no significant difference in overall survival (OS) between the high p53 and low p53 groups. In patients with mutant KRAS, those in the high p53 group exhibited significantly longer OS than those in the low p53 group (p = 0.017, log-rank test). In the multivariate analysis, serum p53 antibody level was an independent predictor of OS in mCRC patients (high vs. normal; hazard ratio 0.438, 95% confidence interval 0.178-0.974, p < 0.05). CONCLUSIONS:Serum anti-p53 antibody level may be an independent predictor of OS in mCRC patients with KRAS mutant tumors.

摘要

背景: 血清 anti-p53 抗体作为结直肠癌的肿瘤标志物被临床应用。然而,其在转移性结直肠癌 (mCRC) 患者中的预后意义仍不清楚。KRAS 状态可能影响宿主对肿瘤进展的免疫反应。在本研究中,我们研究了野生型 KRAS 和突变型 KRAS 接受全身化疗的 mCRC 患者血清 anti-p53 的预后意义。 方法: 回顾性分析 150 例 mCRC 患者一线化疗前血清 anti-p53 抗体的检测结果。根据血清 anti-p53 抗体水平将患者分为高 p53 组和低 p53 组。结合 KRAS 状态评价血清 anti-p53 水平与临床结局的相关性。 结果: 野生型 KRAS 患者 97 例 (64.7%),突变型 KRAS 患者 53 例 (35.3%)。在对所有患者的分析中,高 p53 组和低 p53 组之间的总生存期 (OS) 没有显著差异。在突变型 KRAS 患者中,高 p53 组的 OS 明显长于低 p53 组 (p = 0.017,log-rank 检验)。在多变量分析中,血清 p53 抗体水平是 mCRC 患者 OS 的独立预测因子 (高 vs.正常; 风险比 0.438,95% 置信区间 0.178-0.974,p <0.05)。 结论: 血清 anti-p53 抗体水平可能是 KRAS 突变肿瘤患者 OS 的独立预测因子。

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影响因子:3.72
发表时间:2020-01-21
DOI:10.1093/ibd/izz323
作者列表:["Prathapan KM","Ramos Rivers C","Anderson A","Koutroumpakis F","Koutroubakis IE","Babichenko D","Tan X","Tang G","Schwartz M","Proksell S","Johnston E","Hashash JG","Dunn M","Wilson A","Barrie A","Harrison J","Hartman D","Kim SC","Binion DG"]

METHODS:BACKGROUND:Peripheral blood eosinophilia (PBE) is a biomarker of an aggressive multiyear natural history in adults with inflammatory bowel diseases (IBDs). Additionally, PBE at diagnosis is associated with higher disease activity in pediatric-onset IBD. We sought to determine if PBE can function as a biomarker of long-term disease severity in pediatric-onset IBD patients who are followed into adulthood. METHODS:We analyzed a consented, prospective, natural history IBD registry at an adult tertiary center from 2009 to 2018. Prevalence of PBE was evaluated in both pediatric- and adult-onset IBD patients. Demographics, clinical characteristics, and health care utilization data were compared in patients with and without PBE. RESULTS:Among 2800 adult IBD patients, 23.4% had pediatric-onset disease. PBE was found in 34% of the pediatric-onset patients compared with 26.8% of the adult-onset IBD patients (P < 0.001). In the pediatric-onset IBD cohort, PBE was associated with higher rates of allergies (P < 0.0001), but not of asthma, allergic rhinitis, or primary sclerosing cholangitis. In the adult IBD patients with pediatric-onset disease, PBE was associated with higher rates of C-reactive protein elevation (P < 0.0001), erythrocyte sedimentation rate elevation (P < 0.0001), higher health care utilization, and higher average health care charges per year (P < 0.00001). CONCLUSIONS:Peripheral blood eosinophilia was more prevalent in adult IBD patients with pediatric-onset compared with adult-onset disease. Among all IBD patients with long-term follow-up, PBE defined a subgroup with more severe illness. These data suggest that PBE may be a biomarker for a high-risk subgroup with high cost trajectory and long-term severity in pediatric-onset IBD that persists into adulthood.

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影响因子:3.72
发表时间:2020-01-21
DOI:10.1093/ibd/izz331
作者列表:["Ronchetti S","Gentili M","Ricci E","Migliorati G","Riccardi C"]

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关键词: GILZ IBD 自身免疫 炎症
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