title: Assessment of the potential diagnostic value of serum p53 antibody for cancer: a meta-analysis.
abstract: BACKGROUND
  Mutant p53 protein over-expression has been reported to induce serum antibodies against p53. We assessed the diagnostic precision of serum p53 (s-p53) antibodies for diagnosis of cancer patients and compared the positive rates of the s-p53 antibody in different types of cancers.
  
  
  METHODS
  We systematically searched PubMed and Embase, through May 31, 2012. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were pooled separately and compared with overall accuracy measures using diagnostic odds ratios (DORs) and Area under the curve(AUC). Meta regression and subgroup analyses were done, and heterogeneity and publication bias were assessed.
  
  
  RESULTS
  Of 1089 studies initially identified, 100 eligible studies with 23 different types of tumor met the inclusion criteria for the meta-analysis (cases = 15953, controls = 8694). However, we could conduct independent meta analysis on only 13 of 36 types of tumors. Approximately 56% (56/100) of the included studies were of high quality (QUADAS score≥8). The summary estimates for quantitative analysis of serum p53 antibody in the diagnosis of cancers were: PLR 5.75 (95% CI: 4.60-7.19), NLR 0.81 (95%CI: 0.79-0.83) and DOR 7.56 (95% CI: 6.02-9.50). However, for the 13 types of cancers on which meta-analysis was conducted, the ranges for PLR (2.33-11.05), NLR (0.74-0.97), DOR (2.86-13.80), AUC(0.29-0.81), and positive rate (4.47%-28.36%) indicated significant heterogeneity. We found that breast, colorectal, esophageal, gastric, hepatic, lymphoma, lung and ovarian cancer had relatively reasonable diagnostic accuracy. The remaining results of the five types of cancers suggested that s-p53 antibody had limited value.
  
  
  CONCLUSIONS
  The current evidence suggests that s-p53 antibody has potential diagnostic value for cancer, especially for breast, colorectal, esophageal, gastric, hepatic, lymphoma, lung and ovarian cancer. The results showed that s-p53 antibody had high correlation with cancers.
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Medical Quality Control, 302 PLA hospital, Beijing, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Hepatobiliary Surgery, 302 PLA hospital, Beijing, China.
authors.forename: Lingxiang
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Meilan
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Li
mesh_terms: D000906:Antibodies / Q000097:blood / Q000276:immunology*; D014408:Biomarkers, Tumor; D006801:Humans; D009154:Mutation; D009369:Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology*; D016017:Odds Ratio; D011379:Prognosis; D017594:Publication Bias; D015203:Reproducibility of Results; D016159:Tumor Suppressor Protein p53 / Q000235:genetics / Q000276:immunology*
chemical_list: D000906:Antibodies; D014408:Biomarkers, Tumor; D016159:Tumor Suppressor Protein p53