Serum antibodies against p53 in relation to cancer risk and prognosis in breast cancer: a population-based epidemiological study

To perform an epidemiological evaluation of the predictive value of p53 aut oantibodies in breast cancer, we measured antibodies against p53 in serum s amples from 165 breast cancer patients in comparison with serum samples fro m 330 healthy controls, selected from the same population as the cases and matched for age, sex and specimen storage time. Median age of patients was 51. years (range 25-64 years). Presence of serum p53 autoantibodies was ana lysed by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western blotting. The lower ELISA reactivities were similar for cases and controls . but presence of high-level reactivity was more common among cases than am ong controls [odds ratio (OR) 9.03, 95% confidence interval (Cl) 2.40-50.43 ]. Presence of Western blot-detected p53 autoantibodies had a very similar association (OR 10.8, CI 3.0-59.4). Among the cases, we also studied whethe r there was any correlation between level of anti-p53 antibodies and stage of the disease or survival. There was no significant correlation between pr esence of antibodies and stage of the disease. There was a significant nega tive correlation between presence of p53 antibodies and survival (P = 0.003 ). A stepwise multivariate cox regression analysis showed that T-stage, age and presence of anti-p53 antibodies were significant independent prognosti c variables, with a dose-dependent negative effect on survival for all thre e variables. We conclude that presence of anti-p53 antibodies are of signif icance both for the risk of having breast cancer and the risk of dying from breast cancer.