Year 2017, Volume 39 , Issue 3, Pages 546 - 554 2017-09-19

Is there diagnostic and prognostic importance of serum anti-p53 antibody level in lung cancer?
Akciğer Kanserinde serum anti-p53 antikor düzeyinin tanısal ve prognostik önemi var mı?

Zekiye Hasbek [1] , Birsen Yücel [2] , Ömer Tamer Doğan [3] , Serdar Berk [4] , İsmail Sarı [5] , Yavuz Silig [6] , Mehmet Metin Şeker [7] , Seyit Ahmet Ertürk [8]


Objective: 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.

Method: 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).

Conclusions: Even though 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.

Amaç: Akciğer kanseri dünya genelinde kansere bağlı ölümlerin önde gelen nedenidir. Tanısal cihazlar ve teknolojik gelişmelere bağlı tedavi seçeneklerinde ilerlemeye rağmen, akciğer kanseri hastalarında genel mortalite oranı hala yüksektir. Akciğer kanseri hastalarında sağkalım oranları, özellikle ilerlemiş inoperabl hastalıkta, immunoterapi gibi yeni tedavi seçeneklerine rağmen düşüktür. p53, kanser hastalarının %60-70’inde mutasyona uğramaktadır ve bu nedenle son zamanlarda yapılan çalışmalar göstermektedir ki, serum anti-p53 antikorunun, over, özefagus, meme ve akciğer kanseri gibi bazı kanser türlerinin dedekte edilmesinde biyobelirteç olarak dikkate alınabilir. Bu çalışmada, akciğer kanseri hastalarında, serum anti-p53antikor düzeylerinin tanısal ve prognostik önemini araştırmayı amaçladık.

Yöntem: Çalışmaya akciğer kanseri (AK) tanısı nedeniyle evreleme için 18F-FDG-PET / BT görüntüleme amacı ile bölümümüze sevk edilen hastalar, toraks BT’sinde şüpheli pulmoner nodül olup, patolojik FDG birikimi göstermeyen  hastalar (NAPN= Non-avid FDG gösteren pulmoner nodül) ve sağlıklı gönüllüler dahil edildi. Serum anti-p53antikor düzeyleri tüm hastalarda ELISA yöntemi ile ölçüldü. Hastaların ortalama takip süresi 13 ay idi.

Bulgular: Çalışmaya toplam 65 AK hastası (58E/7K), 47 NAPN hastası (20E/27K) ve 34 sağlıklı gönüllü (26E /8K) dahil edildi. Ortalama serum anti-p53antikor seviyeleri AK hastalarında 3.4ng/mL, NAPN hastalarında 3.77ng /mL, sağlıklı gönüllülerde 3.07 ng/ mL idi. AK hastaları ile NAPN hastaları arasında serum anti-p53antikor düzeyi için istatistiksel olarak anlamlı fark yoktu (p = 0.678). Hatta, hastalar ve sağlıklı gönüllüler arasında serum anti-p53Ab düzeyi için istatistiksel olarak anlamlı fark yoktu (p = 0.377). Hastaların iki yıllık medyan sağkalımı 14 aydı. Hastaların sağkalım hızında, serum anti-p53Ab düzeyinin > 3.4 ng/ mL veya ≤3.4 ng/ mL olmasının herhangi bir etkisinin olmadığı bulundu (p = 0.652).

Sonuç: Anti-p53antikoru, karsinogeneziste çok önemli olmasına rağmen, serum anti-p53antikor düzeyinin akciğer kanseri tanısında ve sağkalım oranlarında tek başına önemli olmadığını düşünüyoruz. Karsinogeneziste birden fazla faktör vardır ve bu durumun nedeni olabilir. Akciğer kanseri hastalarının teşhisi için serum anti-p53antikor düzeylerinin bilinen bir katof değeri yoktur. Bu nedenle, bu antikorun tümör spesifikliği olmadığını ve serum anti-p53antikor düzeyinin akciğer kanseri taraması için uygun olmadığını düşünüyoruz. 

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Subjects Health Care Sciences and Services
Journal Section Medical Science Research Articles
Authors

Author: Zekiye Hasbek

Author: Birsen Yücel

Author: Ömer Tamer Doğan

Author: Serdar Berk

Author: İsmail Sarı

Author: Yavuz Silig

Author: Mehmet Metin Şeker

Author: Seyit Ahmet Ertürk

Dates

Publication Date : September 19, 2017

APA Hasbek, Z , Yücel, B , Doğan, Ö , Berk, S , Sarı, İ , Silig, Y , Şeker, M , Ertürk, S . (2017). Is there diagnostic and prognostic importance of serum anti-p53 antibody level in lung cancer? . Cumhuriyet Medical Journal , 39 (3) , 546-554 . DOI: 10.7197/223.v39i31705.347453