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

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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/μL) without recurrence had an abnormal s-p53Ab test during follow-up. Among the remaining low-level (10 U/μL ≤ s-p53Ab ≤ 76 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.

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Acknowledgment

We thank Miao-Chen Ko for assistance with the assay for s-p53 antibodies and Professor James Tsai-Yuan Wu for his valuable discussions. This study was supported by grant NSC90-2314-B-182A-11 from the National Science Council (R. Tang) and grants DOH85-HR-516, DOH86-HR-516 and DOH87-HR-516 from the National Health Research Institute, Department of Health, Executive Yuan, ROC (L.L. Hsieh).

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Authors and Affiliations

  1. Department of Surgery, Colorectal Section, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan

    Reiping Tang MD, Chien Yuh Yeh MD, Jeng-Yi Wang MD, Chung Rong Changchien MD & Jinn-Shiun Chen MD

  2. Department of Public Health, Chang Gung University, Tao-Yuan, Taiwan

    Ling Ling Hsieh DrPH

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  1. Reiping Tang MD
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  2. Chien Yuh Yeh MD
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Correspondence to Ling Ling Hsieh DrPH.

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Tang, R., Yeh, C.Y., Wang, JY. et al. Serum p53 Antibody as Tumor Marker for Follow-Up of Colorectal Cancer After Curative Resection. Ann Surg Oncol 16, 2516–2523 (2009). https://doi.org/10.1245/s10434-009-0578-2

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