title: Prognostic Role of Serum Antibody Immunity to p53 Oncogenic Protein in Ovarian Cancer: A Systematic Review and a Meta-Analysis.
abstract: OBJECTIVE
  Serum p53 autoantibodies (p53-AAbs) are the product of an endogenous immune response against p53 overexpression driven by the ovarian tumour. The p53-AAbs are detectable only in a subset of patients. To date, the evidence of an association between the presence of p53-AAbs and ovarian cancer outcomes has been poorly investigated.
  
  
  METHODS
  A systematic literature search was performed to identify eligible studies investigating the association of serum p53-AAbs and overall survival (OS) and disease free survival (DFS). Associations between presence of serum p53-AAbs and baseline tumour characteristics were also evaluated. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CI) were computed to estimate the prognostic impact of serum p53-AAbs. Heterogeneity between studies was assessed.
  
  
  RESULTS
  A total of 583 patients (7 studies) for OS and 356 patients (4 studies) for DFS were included in the meta-analysis. Presence of p53-AAbs was not associated to OS (pooled uni- multivariate HR = 1.09; 95% CI: 0.55-2.16), and a large heterogeneity was found. When only multivariate HRs were pooled together (4 studies), presence of p53-AAbs was significantly associated to a better OS (pooled HR = 0.57; 95% CI: 0.40-0.81), and no significant heterogeneity was observed. A reduced DFS was associated to p53-AAbs (pooled uni- multivariate HR = 1.37; 95% CI: 0.83-2.25), though not significantly and with a moderate heterogeneity.
  
  
  CONCLUSIONS
  The prognostic significance of serum p53-AAbs in ovarian cancer was diverging according to uni or multivariate models used. Since the results of this work were based on only few investigations, large prospective studies are needed to better define the role of antibody immunity against p53.
authors.affiliation: Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy.
authors.forename: Marica
authors.initials: M
authors.lastname: Garziera
authors.affiliation: Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy.
authors.forename: Marcella
authors.initials: M
authors.lastname: Montico
authors.affiliation: Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Bidoli
authors.affiliation: Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Scalone
authors.affiliation: Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sorio
authors.affiliation: Department of Gynecological Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Giorda
authors.affiliation: Department of Gynecological Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Lucia
authors.affiliation: Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Toffoli
mesh_terms: D001323:Autoantibodies / Q000097:blood* / Q000276:immunology*; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000276:immunology; D011379:Prognosis; D016159:Tumor Suppressor Protein p53 / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D016159:Tumor Suppressor Protein p53