Abstract
BackgroundMutant p53 protein over-expression has been reported to induce serum antibodies against p53. We assessed the diagnostic precision of serum p53 (s-p53) antibodies for diagnosis of cancer patients and compared the positive rates of the s-p53 antibody in different types of cancers.MethodsWe systematically searched PubMed and Embase, through May 31, 2012. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were pooled separately and compared with overall accuracy measures using diagnostic odds ratios (DORs) and Area under the curve(AUC). Meta regression and subgroup analyses were done, and heterogeneity and publication bias were assessed.ResultsOf 1089 studies initially identified, 100 eligible studies with 23 different types of tumor met the inclusion criteria for the meta-analysis (cases = 15953, controls = 8694). However, we could conduct independent meta analysis on only 13 of 36 types of tumors. Approximately 56% (56/100) of the included studies were of high quality (QUADAS score≥8). The summary estimates for quantitative analysis of serum p53 antibody in the diagnosis of cancers were: PLR 5.75 (95% CI: 4.60–7.19), NLR 0.81 (95%CI: 0.79–0.83) and DOR 7.56 (95% CI: 6.02–9.50). However, for the 13 types of cancers on which meta-analysis was conducted, the ranges for PLR (2.33–11.05), NLR (0.74–0.97), DOR (2.86–13.80), AUC(0.29–0.81), and positive rate (4.47%–28.36%) indicated significant heterogeneity. We found that breast, colorectal, esophageal, gastric, hepatic, lymphoma, lung and ovarian cancer had relatively reasonable diagnostic accuracy. The remaining results of the five types of cancers suggested that s-p53 antibody had limited value.ConclusionsThe current evidence suggests that s-p53 antibody has potential diagnostic value for cancer, especially for breast, colorectal, esophageal, gastric, hepatic, lymphoma, lung and ovarian cancer. The results showed that s-p53 antibody had high correlation with cancers.
Highlights
Cancer is the second leading cause of death following heart disease, accounting for 23% of all deaths [1]
Our objective was to obtain the best estimates of the diagnostic accuracy of serum p53 (s-p53) antibody for detection of cancers, and to make comparisons about the diagnostic value of s-p53 antibody in different types of cancers by performing a systematic review and meta-analysis
Inclusion criteria for the primary studies were as follows: (i) participants: all cases must have been diagnosed by pathologic examination of biopsied specimens, serum must have been collected for anti-p53 analysis before any treatment, e.g. chemotherapy or radiotherapy, and controls were without other cancers, (ii) index test: studies evaluated the diagnostic value of s-p53 antibody in cancer patients, (iii) outcome: studies reported the positive values of the cases and controls, and the results of an individual study on diagnostic accuracy could be summarized in a 262 table, (iv) study design: No restrictions were made with respect to study design or data collection
Summary
Cancer is the second leading cause of death following heart disease, accounting for 23% of all deaths [1]. In the serum of healthy subjects, the presence of p53 protein and anti-p53 antibodies are extremely rare [5]. Mutations in this gene cause an accumulation of nonfunctional proteins, due to increased stability and a longer half-life of several hours compared with the 20 min half-life for wild-type p53 [5]. A large number of studies on the potential diagnostic value of serum p53 antibody for a variety of cancers have been published and have reported varying results. We assessed the diagnostic precision of serum p53 (s-p53) antibodies for diagnosis of cancer patients and compared the positive rates of the s-p53 antibody in different types of cancers
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