Clinical significance of serum and ascitic p53 autoantibodies in epithelial ovarian carcinoma

BACKGROUND. Accumulation of mutated p53 in malignant cells can lead to the generation of anti-p53 autoantibodies in the serum and other body fluids of cancer patients. This retrospective study was performed to evaluate the pr ognostic significance of preoperative serum and ascitic anti-p53 antibodies in advanced ovarian carcinoma. METHODS, In 113 ovarian carcinoma patients who presented with significant a mounts of ascites, anti-p53 autoantibodies were determined by a highly spec ific enzyme-linked immunosorbent assay of blood and ascites. Disease free a nd overall survival of study patients was estimated by the product limit me thod of Kaplan and Meier. Differences in survival were examined according t o criteria of Mantel and Breslow. A multiple regression analysis based on t he Cox proportional hazards model was used to determine the independence of prognostic variables. RESULTS. Serum and ascitic anti-p53 antibodies were found in 28 (25%) and 2 1 (19%) of the study patients, respectively. In univariate analysis, detect ion of anti-p53 antibodies in ascites but not in serum was found to be a si gn of unfavorable disease free survival (P < 0.003) and overall survival (P < 0.01). Multivariate analysis revealed that anti-p53 positivity in ascite s retained independent significance only in the prediction of adverse progr ession free survival (P < 0.01). CONCLUSIONS, The generation of a humoral immune response against p53 protei n in the close tumor environment, as demonstrated by the occurrence of p53 autoantibodies in the ascitic fluid of ovarian carcinoma patients, is assoc iated with poor disease free survival. Cancer 2000;88:1432-7. (C) 2000 Amer ican Cancer Society.