Fd. Vogl et al., Autoimmunity against p53 predicts invasive cancer with poor survival in patients with an ovarian mass, BR J CANC, 83(10), 2000, pp. 1338-1343
Serum autoantibodies against the p53 protein (p53 AAb) were analysed with a
newly developed enzyme-linked immunosorbent assay (ELISA) based on highly
purified and renatured p53. In a hospital-based cohort study, preoperative
sera from 113 patients with ovarian cancer, 15 patients with borderline tum
ours and 117 patients with benign tumours of the ovaries were studied. The
prevalence of p53 AAb in patients with invasive cancer was 19% (21/113). No
p53 AAb were found in patients with borderline lesions or benign tumours.
The ELISA had a specificity for malignancy of 99% (1 of 117; false-positive
from a patient with severe diabetes mellitus) and a likelihood ratio (LR+)
for a positive test result of 21.7 (elevated CA125 and malignancy: LR+ 3.7
). p53 AAb were only detectable in patients with immunohistochemical staini
ng of nuclear p53 in the tumour (P = 0.006). Presence of p53 AAb positively
correlated with tumour stage (P = 0.034) and grade (P = 0.009). Kaplan-Mei
er analysis showed both a shortened overall survival (P = 0.0016, log-rank)
and relapse-free survival (P = 0.055) for p53 AAb-positive patients (media
n follow-up 22 months). High titres related to even worse prognosis, p53 AA
b independently related to poor survival adjusting for stage (P = 0.026), g
rade (P = 0.029) and residual disease after surgery (P = 0.005), Preoperati
ve findings of adnexal mass with serum p53 AAb are strongly suggestive of a
n aggressive invasive ovarian cancer. (C) 2000 Cancer Research Campaign.