Serum p53 Antibody as Tumor Marker for Follow-Up of Colorectal Cancer After Curative Resection

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• 作者：Reiping Tang MD (1)
  Chien Yuh Yeh MD (1)
  Jeng-Yi Wang MD (1)
  Chung Rong Changchien MD (1)
  Jinn-Shiun Chen MD (1)
  Ling Ling Hsieh DrPH (2)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2009
• 出版时间：September 2009
• 年：2009
• 卷：16
• 期：9
• 页码：2516-2523
• 全文大小：279KB
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• 作者单位：Reiping Tang MD (1)
  Chien Yuh Yeh MD (1)
  Jeng-Yi Wang MD (1)
  Chung Rong Changchien MD (1)
  Jinn-Shiun Chen MD (1)
  Ling Ling Hsieh DrPH (2)
  
  1. Department of Surgery, Colorectal Section, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
  2. Department of Public Health, Chang Gung University, Tao-Yuan, Taiwan
  

文摘

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/μL) without recurrence had an abnormal s-p53Ab test during follow-up. Among the remaining low-level (10?U/μL?≤?s-p53Ab?≤?6?U/μL, n?=?103) and high-level (s-p53Ab titer?>?76?U/μL, n?=?34) seropositive patients, recurrence defined by s-p53Ab tests resulted in a DOR of 4.3 and ? 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.