title: p53 autoantibodies as potential detection and prognostic biomarkers in serous ovarian cancer.
abstract: BACKGROUND
  This study examined the value of serum p53 autoantibodies (p53-AAb) as detection and prognostic biomarkers in ovarian cancer.
  
  
  METHODS
  p53-AAb were detected by ELISA in sera obtained preoperatively from women undergoing surgery for a pelvic mass. This group included women subsequently diagnosed with invasive serous ovarian cancer (n = 60), nonserous ovarian cancers (n = 30), and women with benign disease (n = 30). Age-matched controls were selected from the general population (n = 120). Receiver operating characteristic curves were constructed to compare the values of p53-AAb, CA 125, and HE4 as a screening biomarker. Kaplan-Meier curves and Cox proportional hazards modeling were used to assess its prognostic value on survival.
  
  
  RESULTS
  p53-AAb were detected in 25 of 60 (41.7%) of serous cases, 4 of 30 (13.3%) nonserous cases, 3 of 30 (10%) benign disease cases, and 10 of 120 (8.3%) controls (combined P = 0.0002). p53-AAb did not significantly improve the detection of cases [area under the curve (AUC), 0.69] or the discrimination of benign versus malignant disease (AUC, 0.64) compared with CA 125 (AUC, 0.99) or HE4 (AUC, 0.98). In multivariate analysis among cases, p53-AAb correlated only with a family history of breast cancer (P = 0.01). Detectable p53 antibodies in pretreatment sera were correlated with improved overall survival (P = 0.04; hazard ratio, 0.57; 95% confidence interval, 0.33-0.97) in serous ovarian cancer.
  
  
  CONCLUSIONS
  Antibodies to p53 are detected in the sera of 42% of patients with advanced serous ovarian cancer.
  
  
  CONCLUSIONS
  Although their utility as a preoperative diagnostic biomarker, beyond CA 125 and HE4, is limited, p53-AAb are prognostic for improved overall survival.
authors.affiliation: Cancer Vaccine Center, Department of Medical Oncology, Dana-Farber Cancer Institute, HIM416, 77 Avenue Louis Pasteur, Boston, MA 02115, USA. kanderson@partners.org
authors.forename: Karen S
authors.initials: KS
authors.lastname: Anderson
authors.forename: Jessica
authors.initials: J
authors.lastname: Wong
authors.forename: Allison
authors.initials: A
authors.lastname: Vitonis
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Crum
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Sluss
authors.forename: Joshua
authors.initials: J
authors.lastname: Labaer
authors.forename: Daniel
authors.initials: D
authors.lastname: Cramer
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000276:immunology; D018394:CA-125 Antigen / Q000097:blood; D018284:Cystadenocarcinoma, Serous / Q000097:blood* / Q000276:immunology / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D030501:Epididymal Secretory Proteins / Q000032:analysis / Q000378:metabolism; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000276:immunology / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D016159:Tumor Suppressor Protein p53 / Q000276:immunology*; D023083:beta-Defensins
chemical_list: D001323:Autoantibodies; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C426184:DEFB126 protein, human; D030501:Epididymal Secretory Proteins; D016159:Tumor Suppressor Protein p53; D023083:beta-Defensins