Is there diagnostic and prognostic importance of serum anti-p53 antibody level in lung cancer?

Zekiye Hasbek, Birsen Yücel, Ömer Tamer Doğan, Serdar Berk, İsmail Sarı, Yavuz Silig, Mehmet Metin Şeker, Seyit Ahmet Ertürk
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Purpose: Lung cancer is the leading cause of cancer-related deaths worldwide. Despite advancement in diagnostic tools and treatment options with technological developments, overall mortality rates in lung cancer patients remains high. Survival rates in lung cancer patients is low especially in advanced diseased inoperable patients in spite of new treatment options like immunotherapy. p53 is mutated in 60-70% of cancer patients and for this reason has been extensively studied recent researches suggest that serum anti-p53Ab can be considered as biomarkers to detect many types of cancers; as ovarian cancer, esophageal cancer, breast cancer and lung cancer. In this study we aimed that are there any diagnostic and prognostic importance of serum anti-p53Ab levels in lung cancer patients.

Methods: Patients were included who were referred to our department with the purpose of 18F-FDG-PET/CT imaging for staging due to lung cancer diagnosis (LC) and patients who were performed 18F-FDG-PET/CT for diagnosis in the cause of the suspected pulmonary nodule in thorax CT but not detected pathologic FDG accumulation (NAPN=pulmonary nodule with non-avid-FDG) and healthy volunteers. Serum anti-p53Ab levels were measured with ELISA method in the all patients. Mean follow up time of patients were 13 months.

Results: A total of 65 LC patients (58M/7F), 47 patients with NAPN (20M/27F), and a total of 34 healthy volunteers (26M/8F) were included in this study. Median serum anti-p53Ab levels are 3.4ng/mL in LC patients, 3.77ng/mL in NAPN patients, 3.07ng/mL in healthy volunteers. There is no statistically significant difference for serum anti-p53Ab level between LC patients and NAPN patients (p=0.678). Moreover there is no statistically significant difference for serum anti-p53Ab level between patients and healthy volunteers (p=0.377). Two-year median survival of patients was 14 month. It has been found that there is no effect of serum anti-p53Ab level whether >3.4 or ≤3.4 on the patient survival rate (p=0.652).

Conclusion: Even though serum anti-p53Ab is very important in carcinogenesis, we think that serum anti-p53Ab level by itself is not important in lung cancer diagnosis and survival rates. There are multiple factors in carcinogenesis and this may be the reason of this situation. There is no known cut off value of serum anti-p53 Ab levels for diagnosis of lung cancer patients.  Therefore we think that this antibody is not tumor spesific and serum anti-p53 Ab level measurement is not appropriate for lung cancer screening.

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