Presence of serum anti-p53 antibodies is associated with pleural effusion and poor prognosis in lung cancer patients

This study was designed prospectively to evaluate the development of anti-p 53 antibodies (Abs) in lung cancer patients in relation to their clinical o utcome. Sera, derived from 125 lung cancer patients, consisting of 14 small cell lung cancers (SCLC) and 111 non-SCLCs (NSCLC), were surveyed. The p53 -null human NSCLC cell line, NCI-H1299, transfected with a human mutant p53 gene was prepared as the source of p53 antigen for immunoblotting analyses to detect the presence of serum anti-p53 Abs, The control group included s era from 10 healthy adults and 14 patients with benign pulmonary diseases. Clinical data including staging and survival were recorded for statistical analyses. The anti-p53 Abs were found in 8% (10 of 125) of the lung cancer patients studied (8.1% of NSCLC versus 7.1% of SCLC patients), whereas none of the control sera had detectable anti-p53 Abs, The presence of anti-p53 Abs was closely associated with malignant pleural effusions (P = 0.001). Th e p53 Ah-positive patients had a worse prognosis than the p53 Ab negative p atients (P < 0.02; median survival, 20 versus 41 weeks). In both univariate and multivariate analyses, the tumor extension and probably the presence o f anti-p53 Abs were significant predictors for cancer death. The developmen t of anti-p53 Abs (n = 9) aas also a predictor for poor survival in patient s with malignant effusions (n = 51). In conclusion, the presence of serum a nti-p53 Abs is closely associated with malignant pleural effusions in lung cancer patients. It may serve as a negative prognostic factor for survival independent of malignant pleural effusions and tumor staging.