Serum p53 antibody: useful for detecting gastric cancer but not for predicting prognosis after surgery
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ORIGINAL ARTICLE
Serum p53 antibody: useful for detecting gastric cancer but not for predicting prognosis after surgery Yoko Oshima1 · Takashi Suzuki1 · Satoshi Yajima1 · Tatsuki Nanami1 · Fumiaki Shiratori1 · Kimihiko Funahashi1 · Hideaki Shimada1,2 Received: 16 March 2020 / Accepted: 19 April 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose To establish the clinicopathological importance of serum p53 autoantibody (s-p53-Ab) titrations in patients with gastric cancer. Methods Preoperative s-p53-Ab titers were analyzed in 448 gastric cancer patients between 2010 and 2017. Seropositive patients were divided into three groups based on their antibody titers: 1.31–10.0 U/mL (low group); 10.1–100 U/mL (medium group); and > 100 U/mL (high group). We evaluated the associations between the s-p53-Abs and clinicopathological factors, carcinoembryonic antigen (CEA) levels, and cancer antigen 19-9 (CA19-9) levels. Overall survival was analyzed by multivariate analyses. Results A total of 72 patients (16%) were positive for s-p53-Abs. The rate of positivity for s-p53-Abs + CEA + CA19-9 was significantly higher than that for CEA + CA19-9, even in stage I gastric cancers. Gender, tumor depth, lymphatic node metastases, and distant metastases were all significantly associated with the presence of s-p53-Abs; however, overall survival was not associated with the antibodies. The patients in the high titer group (> 100 U/mL) had a relatively worse survival than those in the other groups. Conclusions Based on our findings, s-p53-Abs improve the overall rate of positivity for detecting gastric cancer, but the prognostic value of a high s-p53-Ab titer for predicting overall survival is limited. Keywords Serum p53 antibody · Antibody titer · Gastric cancer · Prognosis
Introduction p53 gene mutations are common in gastric cancer [1] and can be detected during the early stages [2]. These mutations generally result in prolongation of the half-life of p53 protein. Overexpression of the mutant p53 protein induces serum p53 autoantibodies (s-p53-Abs). According to 11 previous studies, the rate of positivity for s-p53-Abs in patients Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00595-020-02030-6) contains supplementary material, which is available to authorized users. * Hideaki Shimada [email protected]‑u.ac.jp 1
Department of Surgery, Toho University School of Medicine, Tokyo, Japan
Department of Gastroenterological Surgery and Clinical Oncology, Graduate School of Medicine, 6‑11‑1 Omori‑nishi, Ota‑ku, Tokyo 143‑8541, Japan
2
with gastric cancer ranged from11%–70% [3–13]. Two of these studies [7, 10] used immunoblotting and the other nine used an enzyme-linked immunosorbent assay (ELISA). Although the presence of s-p53-Abs before surgery is known to be associated with advanced-stage gastric cancer [5, 6], the prognostic impact of these antibodies remains controversial [12, 13]. Moreover, none of the previous studies assessed the impact of s-p53-Ab tit
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