Ciculating P53 antibodies in patients with hepatocellular carcinoma

ABSTRACT

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