Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Int J Clin Oncol. 2020 Apr;25(4):651-659. doi: 10.1007/s10147-019-01599-4. Epub 2019 Dec 13.
Serum anti-p53 antibody is used clinically as a tumor marker of colorectal cancer. However, its prognostic significance in patients with metastatic colorectal cancer (mCRC) remains unclear. KRAS status may influence the host immune response against tumor progression. In the present study, we investigated the prognostic significance of serum anti-p53 in mCRC patients with wild-type KRAS and mutant KRAS treated with systemic chemotherapy.
A retrospective study of 150 mCRC patients in whom serum anti-p53 antibody was measured before first-line chemotherapy was conducted. The patients were divided into two groups, high p53 and low p53, based on their serum anti-p53 antibody levels. Associations between serum anti-p53 level and clinical outcomes were evaluated in conjunction with KRAS status.
There were 97 (64.7%) patients with wild-type KRAS and 53 (35.3%) with mutant KRAS. In an analysis of all patients, there was no significant difference in overall survival (OS) between the high p53 and low p53 groups. In patients with mutant KRAS, those in the high p53 group exhibited significantly longer OS than those in the low p53 group (p = 0.017, log-rank test). In the multivariate analysis, serum p53 antibody level was an independent predictor of OS in mCRC patients (high vs. normal; hazard ratio 0.438, 95% confidence interval 0.178-0.974, p < 0.05).
Serum anti-p53 antibody level may be an independent predictor of OS in mCRC patients with KRAS mutant tumors.
血清抗 p53 抗体在临床上被用作结直肠癌的肿瘤标志物。然而，其在转移性结直肠癌（mCRC）患者中的预后意义尚不清楚。KRAS 状态可能影响宿主对肿瘤进展的免疫反应。在本研究中，我们研究了 KRAS 野生型和突变型 mCRC 患者在接受系统化疗后血清抗 p53 对预后的影响。
对 150 例接受一线化疗前检测血清抗 p53 抗体的 mCRC 患者进行回顾性研究。根据血清抗 p53 抗体水平将患者分为高 p53 和低 p53 两组。结合 KRAS 状态评估血清抗 p53 水平与临床结局之间的关系。
97 例（64.7%）患者 KRAS 野生型，53 例（35.3%）KRAS 突变型。在所有患者的分析中，高 p53 组和低 p53 组的总生存期（OS）无显著差异。在 KRAS 突变型患者中，高 p53 组的 OS 明显长于低 p53 组（p=0.017，对数秩检验）。多因素分析显示，血清 p53 抗体水平是 mCRC 患者 OS 的独立预测因素（高 vs. 正常；危险比 0.438，95%置信区间 0.178-0.974，p<0.05）。
血清抗 p53 抗体水平可能是 KRAS 突变型 mCRC 患者 OS 的独立预测因素。
