Serum Anti-p53 Antibodies and p53 Protein Expression and Their Prognostic Relevance in Patients with Gastric Cance / 대한진단검사의학회지

ABSTRACT

BACKGROUND: Several cancer patients have developed antibodies that recognize the overexpressed p53 protein. In some tumor types, the presence of these antibodies is associated with a poor prognosis. Gastric cancer is a highly prevalent disease associated with a high mortality rate, so there is a need for improved serological markers for disease detection and disease behavior. METHODS: To evaluate the clinical relevance of anti-p53 antibodies and tissue p53 protein expression in gastric cancer, we investigated the presence of serum anti-p53 antibodies in 61 gastric cancer patients, using two enzyme-linked immuno-sorbent assay systems (Dianova p53-autoantibodies ELISA Kit, Hamburg, Germany (A); Pharma Cell Anti-p53 ELISA Kit II, Paris, France (B)), and p53 protein expression was immunohistochemically stained. RESULTS: We have detected serum anti-p53 antibodies in 9.8% (6/61), 18.0% (11/61) of gastric cancer patients before operation by using the A and B kit, respectively, but in none of 21 cancer-free individuals. The detectable expression of p53 protein in tissue was recognized in 49.2% (30/61) of gastric cancer patients, and in 100% (6/6) and 72.7% (7/11) of the patients with anti-p53 Ab by using the A and B kit. The presence of anti-p53 antibodies was significantly associated with high tumor stages, lymph node metastasis, advanced cancers, intestinal histological type, larger tumor size and infiltrating type, and short survival. The overexpression of the p53 protein was significantly associated with large sized tumors, advanced cancers, high tumor stage (III, IV), lymph node metastasis, distant metastasis, early death and high recurrence rate, and short survival. A positive rate for gastic CONCLUSIONS: We have shown that anti-p53 antibodies are closely related to p53 protein overexpression in tumor tissues and could be useful not only as a predictor of an unfavorable prognosis before operation, but also as a serological tumor marker for an increase in the detection rate of gastric cancer by a combination assay with anti-p53 antibodies, CEA and CA 19-9, although not as a screening test.