Working Paper Article Version 2 This version is not peer-reviewed

p53 Antibodies as a Diagnostic Marker for Cancer: a Metanalysis

Version 1 : Received: 18 September 2021 / Approved: 20 September 2021 / Online: 20 September 2021 (16:45:40 CEST)
Version 2 : Received: 23 September 2021 / Approved: 24 September 2021 / Online: 24 September 2021 (12:46:26 CEST)

A peer-reviewed article of this Preprint also exists.

Sobhani, N.; Roviello, G.; D’Angelo, A.; Roudi, R.; Neeli, P.K.; Generali, D. p53 Antibodies as a Diagnostic Marker for Cancer: A Meta-Analysis. Molecules 2021, 26, 6215. Sobhani, N.; Roviello, G.; D’Angelo, A.; Roudi, R.; Neeli, P.K.; Generali, D. p53 Antibodies as a Diagnostic Marker for Cancer: A Meta-Analysis. Molecules 2021, 26, 6215.


Importance: p53 is an unequivocal tumor suppressor altered in half cancers. The immune system produces systemic p53 autoantibodies (p53 Abs) in many cancer patients. Objective: The focus of this systemic review and meta-analysis is on the prognostic value of p53 Abs expressed in the serum of patients with solid tumors. Data Sources: All the clinical investigations were searched on PubMed, MBase and Cochrane from 1993 reporting the first study until May 2021. Study Selection: Studies were included that met the following criteria: 1) participants with cancer; 2) outcome results expressed in relation to the presence of a p53 antibody; 3) a primary outcome (disease free survival, overall survival or progression free survival) expressed as hazard ratio (HR). The following exclusion criteria were used: 1) insufficient data available to evaluate outcomes; 2) animal studies; 3) studies with less than 10 participants. 1333 potentially relevant articles; studies as duplicates, non-patients studies or reviews were excluded. After viewing the titles and abstracts of the 52 remaining studies, the full texts of 34 studies were retrieved and 12 studies were included in the analysis. Data Extraction and Synthesis: PRISMA guidelines were used for abstracting and assessing data quality and validity by three independent observers. The summary estimates were generated using a fixed-effect model (Mantel–Haenszel method) or a random-effect model (DerSimonian–Laird-method) depending on the absence or presence of heterogeneity (I2). Main Outcome(s) and Measure(s): The primary study outcome was to determine the prognostic value of p53 Abs from a large population size of patients with solid tumors, as determined before data collection. Results: In total 12 clinical studies and of which 2094 patients were included and it was determined that p53-wt Abs expression in the serum significantly correlated with a worse survival of cancer patients (95% CI 1.48 [1.24, 1.77]; p<0.00001). On the contrary, data from literature indicated that there was a potential association between p53-mut Abs antibodies with better survival. Conclusions and Relevance: This is the first meta-analysis proving the diagnostic utility of p53-Abs for cancer patients, predicting a worse outcome. The serum-p53 value (s-p53-value) could be useful for future theranostics.


Meta-analysis; p53 wild type antibodies; p53 mutant antibodies; cancer survival prognostic factor.


Medicine and Pharmacology, Oncology and Oncogenics

Comments (1)

Comment 1
Received: 24 September 2021
Commenter: Navid Sobhani
Commenter's Conflict of Interests: Author
Comment: figure 4 shows clearly in this new file
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