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 prognostic significance of preoperative serum and ascitic anti-p53 antibodies in advanced ovarian carcinoma.


METHODS
In 113 ovarian carcinoma patients who presented with significant amounts of ascites, anti-p53 autoantibodies were determined by a highly specific enzyme-linked immunosorbent assay of blood and ascites. Disease free and overall survival of study patients was estimated by the product limit method of Kaplan and Meier. Differences in survival were examined according to criteria of Mantel and Breslow. A multiple regression analysis based on the 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 21 (19%) of the study patients, respectively. In univariate analysis, detection of anti-p53 antibodies in ascites but not in serum was found to be a sign of unfavorable disease free survival (P<0.003) and overall survival (P < 0.01). Multivariate analysis revealed that anti-p53 positivity in ascites retained independent significance only in the prediction of adverse progression free survival (P<0.01).


CONCLUSIONS
The generation of a humoral immune response against p53 protein in the close tumor environment, as demonstrated by the occurrence of p53 autoantibodies in the ascitic fluid of ovarian carcinoma patients, is associated with poor disease free survival.
Abendstein
B
B
Department of Obstetrics and Gynecology, Innsbruck University Hospital, Innsbruck, Austria.
Marth
C
C
Müller-Holzner
E
E
Widschwendter
M
M
Daxenbichler
G
G
Zeimet
A G
AG
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001201:Ascites / Q000276:immunology*; D001323:Autoantibodies / Q000032:analysis / Q000097:blood*; D002277:Carcinoma / Q000276:immunology* / Q000473:pathology; D018450:Disease Progression; D018572:Disease-Free Survival; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005544:Forecasting; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation / Q000235:genetics; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000276:immunology* / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000235:genetics / Q000276:immunology*
D001323:Autoantibodies; D016159:Tumor Suppressor Protein p53