Diagnostic relevance of autoantibody detection against inhibitors of apoptosis proteins in colon cancer and colon adenoma

Autoantibodies against cancer‑related antigens may be detected in the sera of patients with various types of cancer, although their clinical utility has not yet been established. In this study, we aimed to demonstrate the diagnostic relevance of autoantibody detection against inhibitor of apoptosis protein (IAP) family members in colon cancer, as compared to anti‑p53 antibody, carcinoembryonic antigen (CEA) and carbohydrate antigen 19‑9. We established an ELISA system using original recombinant proteins of IAP family members (survivin, livin and X‑linked IAP) and measured the expression levels in the sera of 62 healthy donors, 250 patients with colon polyps (adenoma) and 176 patients with colon cancer. When the cutoff value was set as the mean value + 2 standard deviations in healthy donors, anti‑survivin exhibited the highest positivity rate (24.4%) among IAP autoantibodies in cancer patients. Furthermore, the anti‑survivin antibody exhibited a high positivity rate in early‑stage carcinoma and adenoma. In the combination assay, reflecting the significantly high positivity rate of CEA in stage IV tumors, the positivity rate was highest when combining the detection of anti‑survivin antibody and CEA in cancer patients (50.0%), indicating that this combination may not be useful for the diagnosis of early‑stage cancers. By contrast, reflecting the complete independence of anti‑survivin and anti‑p53 antibodies, the combination of detecting these two antibodies resulted in the highest positivity rate (35.6%) in early‑stage disease (stage 0‑I). These results suggest that the combined measurement of anti‑survivin and anti‑p53 antibodies may be useful for the detection of early‑stage colon cancer.