Clinical significance of circulating anti-p53 antibodies in European patients with hepatocellular carcinoma

p53 alterations are considered to be predictive of poor prognosis in hepato cellular carcinoma (HCC) and may induce a humoral response. Anti-p53 serum antibodies were assessed by enzyme-linked immunosorbent assay (ELISA) using purified recombinant human p53 on 130 European HCC patients before treatme nt and during the clinical course of the disease, p53 immunohistochemistry was performed on tumours from the 52 patients who underwent surgery, and DN A sequencing analysis was initiated when circulating anti-p53 antibodies we re detected. Nine (7%) HCC patients had anti-p53 serum antibodies before tr eatment. During a mean period of 30 months of follow-up, all the negative p atients remained negative, even when recurrence was observed. Of the nine p ositive patients, eight were still positive 12-30 months after surgery. The presence of anti-p53 serum antibodies was correlated neither with mutation of the p53 gene nor the serum alpha-fetoprotein levels and clinicopatholog ical characterics of the tumours. However, a greater incidence of vascular invasion and accumulation of p53 protein were observed in the tumours of th ese patients (P< 0.03 and P< 0.01 respectively) as well as a better surviva l rate without recurrence (P= 0.05). In conclusion, as was recently shown i n pancreatic cancer, anti-p53 serum antibodies may constitute a marker of r elative 'good prognosis' in a subgroup of patients exhibiting one or severa l markers traditionally thought to be of bad prognosis.