Vogl F D, Frey M, Kreienberg R, Runnebaum I B
Department of Obstetrics and Gynaecology, University of Ulm, Ulm, 89075, Germany.
Br J Cancer. 2000 Nov;83(10):1338-43. doi: 10.1054/bjoc.2000.1446.
Serum autoantibodies against the p53 protein (p53 AAb) were analysed with a newly developed enzyme-linked immunosorbent assay (ELISA) based on highly purified and renatured p53. In a hospital-based cohort study, preoperative sera from 113 patients with ovarian cancer, 15 patients with borderline tumours and 117 patients with benign tumours of the ovaries were studied. The prevalence of p53 AAb in patients with invasive cancer was 19% (21/113). No p53 AAb were found in patients with borderline lesions or benign tumours. The ELISA had a specificity for malignancy of 99% (1 of 117; false-positive from a patient with severe diabetes mellitus) and a likelihood ratio (LR+) for a positive test result of 21.7 (elevated CA125 and malignancy: LR+ 3.7). p53 AAb were only detectable in patients with immunohistochemical staining of nuclear p53 in the tumour (P = 0.006). Presence of p53 AAb positively correlated with tumour stage (P = 0.034) and grade (P = 0.009). Kaplan-Meier analysis showed both a shortened overall survival (P = 0.0016, log-rank) and relapse-free survival (P = 0.055) for p53 AAb-positive patients (median follow-up 22 months). High titres related to even worse prognosis. p53 AAb independently related to poor survival adjusting for stage (P = 0.026), grade (P = 0.029) and residual disease after surgery (P = 0.005). Preoperative findings of adnexal mass with serum p53 AAb are strongly suggestive of an aggressive invasive ovarian cancer.
采用基于高度纯化和复性的p53新开发的酶联免疫吸附测定（ELISA）分析针对p53蛋白的血清自身抗体（p53 AAb）。在一项基于医院的队列研究中，研究了113例卵巢癌患者、15例交界性肿瘤患者和117例卵巢良性肿瘤患者的术前血清。浸润性癌患者中p53 AAb的患病率为19%（21/113）。在交界性病变或良性肿瘤患者中未发现p53 AAb。ELISA对恶性肿瘤的特异性为99%（117例中有1例；1例患有严重糖尿病的患者出现假阳性），阳性检测结果的似然比（LR+）为21.7（CA125升高与恶性肿瘤：LR+ 3.7）。仅在肿瘤细胞核p53免疫组化染色的患者中可检测到p53 AAb（P = 0.006）。p53 AAb的存在与肿瘤分期（P = 0.034）和分级（P = 0.009）呈正相关。Kaplan-Meier分析显示，p53 AAb阳性患者的总生存期（P = 0.0016，对数秩检验）和无复发生存期（P = 0.055）均缩短（中位随访22个月）。高滴度与更差的预后相关。调整分期（P = 0.026）、分级（P = 0.029）和术后残留疾病（P = 0.005）后，p53 AAb与不良生存独立相关。术前附件包块伴血清p53 AAb的发现强烈提示侵袭性卵巢癌。
