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      Value of anti-p53 antibody as a biomarker for hepatocellular carcinoma : Evidence from a meta-analysis

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          Abstract

          Supplemental Digital Content is available in the text

          Abstract

          Introduction:

          The incidence of hepatocellular carcinoma (HCC) ranks sixth in the world, but its mortality is the third highest due to the lack of early diagnostic markers. Nowadays, the increase of autoantibody levels has been found in many cancers, and many studies have begun to pay attention to the detection of anti-p53 antibodies in HCC. The purpose of this study is to quantitatively and comprehensively analyze the potential diagnostic value of anti-p53 autoantibodies in HCC

          Methods:

          English articles up to November 2019 were collected. The overall sensitivity and specificity were calculated. Besides, the positive likelihood ratio, negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and summary receiver operating characteristic curves of the overall diagnostic accuracy of anti-p53 antibody were calculated by STATA software. Finally, according to the heterogeneity of the results, the subgroup analysis, and the publication bias were performed.

          Results:

          A total of 16 eligible studies were incorporated into this meta-analysis, including 1323 patients with HCC and 1896 control. The pooled sensitivity was 0.28(0.17–0.41) and specificity was 0.98 (0.95–0.99). The pooled DOR was 10.44 (6.31–17.29) and the pooled NLR was 0.74 (0.63–0.86). The area under ROC curve of symmetrical ROC was 0.840.

          Conclusions:

          The anti-p53 antibody has a high specificity for HCC, but the low sensitivity is not perfect and would limit the clinical application. The anti-p53 antibody would help rule out HCC but not help rule in HCC for early diagnosis. Whether combined as a diagnostic panel with other biomarkers or laboratory tests may prove useful requires further study.

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          Most cited references43

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          Is Open Access

          Liquid biopsy in hepatocellular carcinoma: circulating tumor cells and circulating tumor DNA

          Hepatocellular carcinoma (HCC) is one of the most common cancers and a leading cause of death worldwide. Due to latent liver disease, late diagnosis, and nonresponse to systemic treatments, surgical resection and/or biopsy specimens are still generally considered as the gold standard by clinicians for clinical decision-making until now. Since the conventional tissue biopsy is invasive and contains small tissue samples, it is unable to represent tumor heterogeneity or monitor dynamic tumor progression. Therefore, it is imperative to find a new less invasive or noninvasive diagnostic strategy to detect HCC at an early stage and to monitor HCC recurrence. Over the past years, a new diagnostic concept known as “liquid biopsy” has emerged with substantial attention. Liquid biopsy is noninvasive and allows repeated analyses to monitor tumor recurrence, metastasis or treatment responses in real time. With the advanced development of new molecular techniques, HCC circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) detection have achieved interesting and encouraging results. In this review, we focus on the clinical applications of CTCs and ctDNA as key components of liquid biopsy in HCC patients.
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            p53 Antibodies in the sera of patients with various types of cancer: a review.

            T Soussi (2000)
            p53 antibodies (p53-Abs) were discovered 20 years ago during the course of tumor-associated antigens screening. The discovery of p53 mutation and accumulation of p53 in human tumors shed new light on the p53 humoral response. In the present review, we have compiled more than 130 papers published in this specific field since 1992. We demonstrate that p53-Abs are found predominantly in human cancer patients with a specificity of 96%. Such antibodies are predominantly associated with p53 gene missense mutations and p53 accumulation in the tumor, but the sensitivity of such detection is only 30%. It has been demonstrated that this immune response is due to a self-immunization process linked to the strong immunogenicity of the p53 protein. The clinical value of these antibodies remains subject to debate, but consistent results have been observed in breast, colon, oral, and gastric cancers, in which they have been associated with high-grade tumors and poor survival. The finding of p53-Abs in the sera of individuals who are at high risk of cancer, such as exposed workers or heavy smokers, indicates that they have promising potential in the early detection of cancer.
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              • Article: not found

              Autoantibodies: Opportunities for Early Cancer Detection.

              Cancer cells can induce an immunological response resulting in the production of tumor-associated (TA) autoantibodies. These serum immunobiomarkers have been detected for a range of cancers at an early stage before the development of clinical symptoms. Their measurement is minimally invasive and cost effective using established technologies. TA autoantibodies are present in a clinically significant number of individuals and could supplement current screening modalities to aid early diagnosis of high-risk populations and assist the clinical management of patients. Here we review their production, discovery, and validation as biomarkers for cancer and their current and future potential as clinical tools.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                21 August 2020
                21 August 2020
                : 99
                : 34
                : e21887
                Affiliations
                [a ]Department of Hepatopancreatobiliary and Splenic Medicine, Characteristic Medical Center of People's Armed Police Force
                [b ]Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis and Treatment
                [c ]Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, Tianjin, China.
                Author notes
                []Correspondence: Hai Li, Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, No. 403 Xiqing Road, Xiqing District, Tianjin 300380, China (e-mail: haili_tj@ 123456sina.com ).
                Author information
                http://orcid.org/0000-0002-1048-477X
                http://orcid.org/0000-0001-9563-6842
                Article
                MD-D-20-00412 21887
                10.1097/MD.0000000000021887
                7447394
                32846849
                eea485f9-07c8-4c85-a2a4-8331fc69e106
                Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 16 January 2020
                : 15 July 2020
                : 21 July 2020
                Funding
                Funded by: Tianjin Science and Technology Project
                Award ID: 15ZXLCSY00040
                Award Recipient : Hai Li
                Funded by: National Major Science and Technology Projects in the 13th Five-Year Plan
                Award ID: 2018ZX10732-202-004-005
                Award Recipient : Hai Li
                Categories
                4500
                Research Article
                Systematic Review and Meta-Analysis
                Custom metadata
                TRUE

                biomarker,diagnosis,hepatocellular carcinoma,meta-analysis,p53 antibody

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