Search for predictors of chemotherapy efficacy and development of minimally invasive treatment for early-stage esophageal cancer

2022 Fiscal Year Final Research Report

• Project/Area Number: 21K15923
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Osaka University
• Principal Investigator: Tsujii Yoshiki 大阪大学, 大学院医学系研究科, 助教 (80795170)
• Project Period (FY): 2021-04-01 – 2023-03-31
• Keywords: 食道表在癌 / 化学療法 / 効果予測

Outline of Final Research Achievements

We investigated the impact of CRT for head & neck cancer (HNC) on superficial esophageal carcinoma (SEC) in relation to immunohistochemical staining results of pretreatment specimens and explored predictors of response to chemotherapy for SEC. Twenty-six patients with overlapping HNC and SEC (38 lesions of SEC) who underwent CRT for HNC first were included. The effect of CRT for HNC on SEC were investigated; the effect for SEC was evaluated based on endoscopic findings; endoscopic biopsy specimens were used for histological evaluation. For immunostaining, p53, Ki-67, MRP2, HOXA13, Glypican1, and ALDH1A1, were selected, and their expression was examined to analyze the relationship. Results showed 38 lesions with median diameter of 30 mm, depth of cEP- LPM/MM-SM1/SM2=29/4/5 lesions, of which 6 disappeared, 8 shrank, 22 remained unchanged, and 2 increased. No significant relationship was found between chemotherapy efficacy and the degree of expression of each protein.

Free Research Field

消化器内科学

Academic Significance and Societal Importance of the Research Achievements

現在、食道癌に対する標準治療は、内視鏡治療、化学放射線療法、外科的手術の3本柱であるが、より低侵襲な治療方法の開発が社会的に望まれるため、今回、早期食道癌に対する化学療法の効果予測因子を探索した。進行食道癌に対する化学療法予測因子は数多く報告されている一方で、早期食道癌に対する効果については、報告がほとんどないため、本研究の結果によりまずまずの感受性が示された点においては、学術的意義があったと考えられる。ただ、既報を元に選択した蛋白は、本研究において効果予測として有意な因子とはならなかった。今後さらに病変数を増やし、候補分子を挙げて検討を重ねる必要がある。