Diagnostic and Prognostic Impact of Serum p53 Antibody Titration in Colorectal Cancer

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Background: Although s-p53-Abs titers of cancer patients are distributed in wide range, the diagnostic and prognostic significance of preoperative and perioperative s-p53-Abs titers have not been evaluated in detail. Methods: Preoperative and postoperative s-p53-Abs titers were assayed in 527 consecutive colorectal cancer patients surgically treated at Toho University Hospital between January 2010 and December 2014, and their associations with prognostic and clinicopathological variables were evaluated. To evaluate the clinical impact of s-p53-Abs titers, seropositive patients were divided into four groups by antibody titer as follows: 1.3 - 10 U/mL (very low); 10.1 - 50 U/mL (low); 50.1 - 200 U/mL (medium-high); and >200 U/mL (extremely high). The impact of perioperative change in the titer on survival was also evaluated. Results: Among 527 patients, 155 (29.4%) were positive for s-p53-Abs. The positive rate of combination with CEA, CA19-9, and s-p53-Abs was significantly higher than the combination with CEA and CA19-9. Tumor depth, lymphatic invasion, and CA19-9 were significantly associated with s-p53-Abs status. Although the overall prognostic value of s-p53-Abs was not significant, the subgroup analysis found that extremely high titers were not associated with recurrence or poor survival. Tumor recurrences were more likely to occur in patients with medium-high titers. Although the medium-high-titer group showed poor survival, the extremely high-titer group showed better survival than the other groups. Conclusions: Combination assay with CEA, CA19-9, and s-p53-Abs was useful to increase positive rates to detect colorectal cancers. Although s-p53-Abs seropositivity itself was not independently associated with survival, high titers of s-p53-Abs had a paradoxical impact on tumor recurrence and patient survival.

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