Ciculating P53 antibodies in patients with hepatocellular carcinoma

Hepatocellular carcinoma [HCC] is one of the most common malignant tumours worldwide. The poor survival after diagnosis has led to the introduction of screening programs using alpha-fetoprotein [AFP], real time ultrasound scanning and computed tomography. Unfortunately, the accuracy of these programs is limited especially in small HCCs, hence there is clearly a need for other markers of malignant changes that can be used to screen cirrhotic patients. The aim of the present study was to assess the value of using a specific ELISA for the detection of antibodies directed against p53 protein as a scneening test for early detection and characterization of HCC. The present study included 34 patients with HCC and 20 control patients with non-neoplastic chronic liver diseases admitted to Tanta University Hospital and National Liver Institute Menoufeya University. The diagnosis in all the cases was based on histopathological examination of sonar-guided liver biopsies. Tumour size and number were determined at the time of presentation by ultrasound and CT scanning, HBsAg and HCV-antibody status were determined Serum bilirubin, ALT, AST, serum albumin, prothrombin activity, and serum alpha-fetoprotein [AFP] concentrations were measured. Circulating p53 antibodies were looked for using ELISA technique specific for detection of antibodies to p53 protein in serum samples. Positivity for circulating anti-p53 was detected in 16/34 of the HCC patients but in none of the control group with a sensitivity of 47.1%, and specificity of 100%. Positivity for AFP [>500 ng/ml] was found in 14/34 of HCC cases but in none of the control group [sensitivity 41.2%, specificity 100%]. The anti-p53 positivity was not significantly correlated to AFP-positivity [p = 0.4], Screening of patients and controls by both tests increased the sensitivity of detection of HCC up to 73.5%. The positivity for anti-p53 was significantly associated with the degree of HCC differentiation. It was significantly higher in well [9/12; 75%] than in poorly differentiated tumours [7/22; 32%] [p < 0.05], but it had not any significant relation with tumour size and number, nor was it related to hepatitis B or C status, background liver diseases, age, sex, serum bilirubin, serum albumin, ALT, AST, or prothrombin activity. In conclusion, detection of anti-p53 by ELISA is convenient and may be a valuable addition to the current screening tests for HCC with the potential to detect tumours at an early, and therefore more treatable, stage

Is there a role for islet cell antibodies [ICA] in hepatitis C virus-diabetes mellitus mysterious link?

There is an increasing evidence of strong association between hepatitis C virus [HCV] and diabetes mellitus particularly, non-insulin dependent diabetes mellitus [NIDDM], the cause of which is still obscure. Autoantibodies of different types have been screened in-patients with HCV. The presence of islet cell antibodies was conducted to clarify the possible role of ICA in this association and to find any correlation between ICA and other autoantibodies. We studied 48 patients with HCV as diagnosed by RIBA II and PCR. Patients were divided into group I [NIDDM group] and group II [Non diabetic group]. Group I comprised 14 males and 10 females with a mean age of 39,75 +/- 6 years, group II comprised 16 males and 8 females with a mean age of 39.60 +/- 5.8 years. Non of the patients received antiviral therapy. They were tested for: Blood glucose, liver functions [ALT, AST, Alkaline Phosphatase, Albumin and Prothrombin time]. The following non organ-specific autoantibodies were screened: Anti-mitochondrial antibodies [AMA], anti-smooth muscle antibodies [ASMA], and antinuclear antibodies [ANA]. Islet cell antibodies [ICA] were screened in their sera by indirect immunoflurescence test [Inova Lite, Research kit]. The results of the study showed relatively increased prevalence of ICA in group I [33.3%] than in group II [12.5%], but the difference was statistically non significant [P > 0.05], In group I A MA, ASMA and ANA were positive in 8.3%, 41.6% and 20.8% respectively, while in group II they were positive in 8.3%, 37.5%. and 16.7% respectively, with no statistical significant difference between both groups. ICA correlated significantly with ASMA in both groups and with ANA only in group II. No correlation was detected between ICA and AMA. Neither ICA nor other studied auto-antibodies did correlate to any of the studied liver functions, in group I, ICA did not correlate to either patient's age, sex or family history of diabetes. In [1] The HCV-Diabetes Mellitus Link deserves careful evaluation, [2] ICA alone could not explain the relatively high incidence of diabetes mellitus in HCV patients, [3] ICA might be present in the sera of HCV patients as a part of immune disturbances present in the disease. [4] There is a significant correlation between ICA and ASMA, [4] HCV might trigger an autoimmune phenomena that persist even after cessation of the disease activity, [5] other possible mechanisms for HCV-diabetes mellitus link might be: iron overload, metabolic effect, receptor and /or post-receptor effect, viral pancreatitis or HLA association