In human pancreatic carcinoma (PCa) mutations in the p53 tumor suppres
sor gene are present in up to 50% of cases. Conformational change and
cellular accumulation, together with subsequent release of mutant and
normal p53 protein from transformed cells, may initiate a B-cell respo
nse with generation of circulating autoantibodies to p53 protein (anti
-p53). In the present study we analyzed the sera of 85 consecutive pat
ients with acute pancreatitis (N = 19), chronic pancreatitis (N = 33),
and PCa (N = 33) to evaluate the specificity of autoantibodies to p53
protein as a serological marker for PCa. Detection of anti-p53 was pe
rformed using an enzyme-linked immunosorbent assay system with immobil
ized recombinant wild-type p53 protein. Autoantibodies to p53 were det
ectable in 1 of 19 patients with acute (5.3%) and in 4 of 33 patients
with chronic pancreatitis (12.1%). All anti-p53-positive patients with
acute or chronic pancreatitis were carefully examined and no underlyi
ng malignant disease was found. During follow-up (range, 281-647 days;
mean, 472 days) none of these patients showed any evidence for subseq
uent development of PCa or any other malignant disease, in patients wi
th PCa, anti-p53 was detected in 6 of 33 cases, resulting in a sensiti
vity of 18.2% with a specificity of 90.4%. In contrast to anti-p53, de
tection of serum carbohydrate antigen (CA 19-9) resulted in a sensitiv
ity and specificity of 69.7 and 71.2% (CA 19-9, > 37 U/ml) and 51.5 an
d 96.2% (CA 19-9, > 100 U/ml) for the detection of PCa, respectively.
Taken together, the sensitivity of anti-p53 formation was Low in patie
nts with PCa (18.2%). Furthermore, the detection of anti-p53 was not s
pecific for malignancy, indicating that severe inflammatory processes
may also induce anti-p53 formation.