p53 Antibodies as a Diagnostic Marker for Cancer: A Meta-Analysis.
Importance: The protein p53 is an unequivocal tumor suppressor that is altered in half of all cancers. The immune system produces systemic p53 autoantibodies (p53 Abs) in many cancer patients. Objective: This systemic review and meta-analysis focuses on the prognostic value of p53 Abs expressed in the serum of patients with solid tumors. Data Sources: All the clinical investigations were searched on PubMed from the first study dated 1993 until May 2021 (date of submission of the manuscript). Study Selection: Studies were included that met the following criteria: (1) participants with cancer; (2) outcome results expressed in relation to the presence of a p53 antibody; (3) a primary outcome (disease-free survival, overall survival or progression-free survival) expressed as hazard ratio (HR). The following exclusion criteria were used: (1) insufficient data available to evaluate outcomes; (2) animal studies; (3) studies with less than 10 participants. As a result, 12 studies were included in the analysis. Data Extraction and Synthesis: PRISMA guidelines were used for abstracting and assessing data quality and validity by three independent observers. The summary estimates were generated using a fixed-effect model (Mantel-Haenszel method) or a random-effect model (DerSimonian-Laird method), depending on the absence or presence of heterogeneity (I2). Main Outcome(s) and Measure(s): The primary study outcome was to determine the prognostic value of p53 Abs from a large population of patients with solid tumors, as determined before data collection. Results: In total, 12 clinical studies involving 2094 patients were included in the meta-analysis, and it was determined that p53 Abs expression in the serum significantly correlated with poorer survival outcomes of cancer patients (95% CI 1.48 [1.24, 1.77]; p < 0.00001). Conclusions and Relevance: This is the first meta-analysis proving the diagnostic utility of p53-Abs for cancer patients in predicting poorer outcomes. The serum-p53 value (s-p53-value) may be useful for future theranostics.
['Sobhani|Navid|N|0000-0003-1381-0283', 'Roviello|Giandomenico|G|', "D'Angelo|Alberto|A|", 'Roudi|Raheleh|R|0000-0001-5023-4743', 'Neeli|Praveen Kumar|PK|', 'Generali|Daniele|D|0000-0001-6002-1530']
D001323:Autoantibodies D014408:Biomarkers, Tumor D005260:Female D006801:Humans D008297:Male D009154:Mutation D009369:Neoplasms D011379:Prognosis D012189:Retrospective Studies D016019:Survival Analysis D016159:Tumor Suppressor Protein p53
p53 meta-analysis cancer survival prognostic biomarker serum p53 antibodies