Prognostic implications of circulating anti-p53 antibodies in lung cancer--a review.

Many independent prognostic markers have been identified for predicting survival and helping in the management of lung cancer cases. p53 protein overexpression and mutation have been the topic of numerous such publications. However, little is known about the role of anti-p53 antibodies as a prognostic marker in lung cancer. We searched the MEDLINE database and the bibliographies of the retrieved manuscripts and reviews. The retrieved studies are grouped according to the cohort studied. Out of 179 citations retrieved, 17 met our criteria. Seven studies used only non-small-cell lung cancer; four studies used only small-cell lung cancer; and six studies used the mixed cohort of both types of lung cancer. The studies varied in the concept design, cohort studied and the methodology. The prognostic role of anti-p53 antibodies in lung cancer remains contradictory and as some studies show an association with poor prognosis, others show a favourable association and still others showing no association what so ever. The frequency of detection of anti-p53 antibody is very low, highly specific with result being independent of the cohort studied. Adequate clinical trials, with optimized cohort, antigen and assay validation, are needed to address patients and physician's concerns regarding these associations.