Serum p53 antibody as tumor marker for follow-up of colorectal cancer after curative resection

Ann Surg Oncol. 2009 Sep;16(9):2516-23. doi: 10.1245/s10434-009-0578-2. Epub 2009 Jun 30.

Abstract

Background: No large-scale studies have examined the use of serial measurements of serum p53 antibodies (s-p53Abs) combined with carcinoembryonic antigen (CEA) measurements during the follow-up of colorectal cancer (CRC) patients after curative resection.

Methods: A highly specific enzyme-linked immunosorbent assay was used to analyze s-p53Abs levels in 305 CRC patients before and after curative resection at a single institution. Agreement between recurrence and serial s-p53Ab and CEA measurements was evaluated by diagnostic accuracy odds ratio (DOR), kappa, and area under receiver operating characteristic curve (AUC).

Results: Among 305 patients, 76 (25%) patients had disease recurrence during follow-up. None of the 168 s-p53Ab seronegative patients (s-p53Ab < 10 U/microL) without recurrence had an abnormal s-p53Ab test during follow-up. Among the remaining low-level (10 U/microL <or= s-p53Ab <or= 76 U/microL, n = 103) and high-level (s-p53Ab titer > 76 U/microL, n = 34) seropositive patients, recurrence defined by s-p53Ab tests resulted in a DOR of 4.3 and infinity, a kappa of 0.35 and 1.00, and an AUC of 0.633 [95% confidence interval (CI), 0.495 to 0.772; P = 0.047], and 1.0 (95% CI, 1.000 to 1.000; P < 0.0001), respectively. Recurrence defined by CEA tests had an AUC of 0.781 (95% CI, 0.654 to 0.909) for low-level and 0.796 (95% CI, 0.611 to 0.982) for high-level seropositive patients.

Conclusions: Agreement between clinical recurrence and serial s-p53Ab test was dependent upon preoperative s-p53Ab level. Serial s-p53Ab testing outperformed CEA testing when predicting clinical recurrence in colorectal cancer patients with an abnormal preoperative s-p53Ab level.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / blood*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Adenocarcinoma, Mucinous / blood*
  • Adenocarcinoma, Mucinous / pathology
  • Adenocarcinoma, Mucinous / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • Carcinoembryonic Antigen / blood
  • Colorectal Neoplasms / blood*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulins / blood*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Tumor Suppressor Protein p53 / blood*
  • Tumor Suppressor Protein p53 / immunology
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Immunoglobulins
  • TP53 protein, human
  • Tumor Suppressor Protein p53