title: Clinical Significance of Serum p53 Antibody in the Early Detection and Poor Prognosis of Gastric Cancer.
abstract: The aim of this retrospective study was to evaluate the clinical relevance of serum p53 antibody (S-p53Ab) as a biomarker and to investigate whether its diagnostic value could be improved when combined with other biomarkers of gastric cancer (GC).
  
  
  
  Serum samples were obtained preoperatively from 208 patients with histologically-confirmed GC, including 126 stage I patients (60.6%). Levels of S-p53Ab were assessed by a commercial laboratory using an anti-p53 detection kit. The cut-off value for S-p53Ab was 1.3 U/ml.
  
  
  
  S-p53Ab was detected in 16.3% (34 of 208) of patients with GC, including 13.6% (22 of 162) of patients with early-stage GC. The positive rates for S-p53Ab, carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) of patients with stage I GC were 10.3% (13/126), 2.4% (3/126), and 8.7% (11/126), respectively. Positivity for S-p53Ab was not associated with CA19-9 or CEA positivity (p=0.098 and 0.053, respectively). The positive rate for a diagnosis of GC increased from 16.3% to 29.3% when S-p53-Ab was combined with CEA in this study. We found no significant correlation between the presence of S-p53Ab in GC and overall survival. Conversely, Cox regression analysis revealed that a high level of CA19-9 was an independent prognostic factor for GC in this series (hazard ratio(HR)=3.864; 95% confidence interval(CI)= 1.248-11.959; p=0.019). Kaplan-Meier analyses demonstrated significant differences in survival between patients with elevated levels of both S-p53Ab and CEA and those with elevated levels of only one or neither.
  
  
  
  The diagnostic rate of S-p53Ab was better than that of CA19-9 and CEA in patients with stage I GC. Combined detection of S-p53Ab and CEA may improve the diagnostic sensitivity and may permit more accurate stratification of GC patients.
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan makuni49@nagasaki-u.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kunizaki
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Fukuda
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Kouki
authors.initials: K
authors.lastname: Wakata
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Tominaga
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Sumida
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Yasutake
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.affiliation: Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Tokyo, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Hamamoto
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.affiliation: Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000912:Antibodies, Neoplasm / Q000097:blood*; D001323:Autoantibodies / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D055088:Early Detection of Cancer; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D016159:Tumor Suppressor Protein p53 / Q000276:immunology*
chemical_list: D000912:Antibodies, Neoplasm; D001323:Autoantibodies; D014408:Biomarkers, Tumor; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53
keywords: Gastric cancer; serum p53 antibody; tumor markers