Atta Mohamed M, el-Masry Samir A, Abdel-Hameed Mohamed, Baiomy Hosam A, Ramadan Naglaa E
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Egypt.
Clin Biochem. 2008 Oct;41(14-15):1131-9. doi: 10.1016/j.clinbiochem.2008.06.006. Epub 2008 Jun 20.
p53 antigen is an oncoprotective antigen and when damaged, leads to production of anti-p53 and also predisposes to various cancers, including hepatocellular carcinoma (HCC). Serum anti-p53 has been proven to have a prognostic value in patients with HCC. The objective of this study was to determine the prevalence and prognostic utility of serum anti-p53 in Egyptian patients with HCC.
Forty one patients with HCC, 26 patients with liver cirrhosis and 29 healthy controls were included in this study. For all the studied groups, we studied the clinical data, abdominal ultrasound (US) findings, biochemical liver function tests, serum alpha-fetoprotein (AFP) levels detected by enzyme immunoassay (EIA) kit and anti-p53 antibody levels by a modified enzyme-linked immunosorbent assay (ELISA). The severity of liver disease was assessed by Child-Pugh and MELD scores. Tumor characteristics were detected by (US) with or without computed tomography (CT) scan. These characteristics included tumor size, number and site. Tumor staging was done using Okuda, Cancer Liver Italian Program (CLIP) and Tokyo staging systems. Also, the overall survival of patients with HCC with reference to p53 antibody level was studied.
The mean age of HCC patients was 57.95+/-8.41. There was a male predominance among HCC patients with male-to-female ratio of 3.6:1. Anti-p53 antibodies were detected in the sera of 68.3% of HCC patients, 50% of liver cirrhosis patients and 17.2% of healthy control subjects. The data showed that HCC patients had a significantly higher mean anti-p53 antibody values (p=0.0001), than both liver cirrhosis patients and healthy control groups. Our results revealed that anti-p53 has a positive significant correlation with AFP (p=0.002), severity of liver disease [Child Pugh score (p=0.02) and MELD score (p=0.0003)], tumor size (p<0.0001), tumor number (p=0.003) and tumor staging systems [Okuda (p=0.04), CLIP (p=0.006) and Tokyo (p<0.0001)]. Also, our results revealed that serum anti-p53 antibodies had a significant association with overall survival of patients with HCC (p=0.019) with a shorter survival time in anti-p53 positive status patients and with higher anti-p53 antibody levels within 19 months follow up.
The detection of anti-p53 antibodies may be suitable for assessing the prognosis of HCC patients. The higher percentage of positivity of anti-p53 antibodies in Egyptian control subjects than reported elsewhere needs further thorough investigation.
p53抗原是一种肿瘤保护抗原，受损时会导致抗p53的产生，还会引发包括肝细胞癌（HCC）在内的各种癌症。血清抗p53已被证明对HCC患者具有预后价值。本研究的目的是确定埃及HCC患者血清抗p53的患病率及其预后效用。
本研究纳入了41例HCC患者、26例肝硬化患者和29名健康对照者。对于所有研究组，我们研究了临床数据、腹部超声（US）检查结果、生化肝功能检查、酶免疫分析（EIA）试剂盒检测的血清甲胎蛋白（AFP）水平以及改良酶联免疫吸附测定（ELISA）检测的抗p53抗体水平。采用Child-Pugh和MELD评分评估肝病严重程度。通过超声（有或无计算机断层扫描（CT））检测肿瘤特征。这些特征包括肿瘤大小、数量和部位。使用Okuda、意大利肝癌项目（CLIP）和东京分期系统进行肿瘤分期。此外，还研究了HCC患者的总生存期与p53抗体水平的关系。
HCC患者的平均年龄为57.95±8.41岁。HCC患者中男性占优势，男女比例为3.6:1。68.3%的HCC患者血清中检测到抗p53抗体，50%的肝硬化患者和17.2%的健康对照者血清中检测到抗p53抗体。数据显示，HCC患者的平均抗p53抗体值显著高于肝硬化患者和健康对照组（p = 0.0001）。我们的结果显示，抗p53与AFP（p = 0.002）、肝病严重程度[Child-Pugh评分（p = 0.02）和MELD评分（p = 0.0003）]、肿瘤大小（p < 0.0001）、肿瘤数量（p = 0.003）以及肿瘤分期系统[Okuda（p = 0.04）、CLIP（p = 0.006）和东京（p < 0.0001）]呈显著正相关。此外，我们的结果显示，血清抗p53抗体与HCC患者的总生存期显著相关（p = 0.019），在抗p53阳性状态的患者中生存时间较短，且在19个月的随访中抗p53抗体水平较高。
抗p53抗体的检测可能适用于评估HCC患者的预后。埃及对照受试者中抗p53抗体阳性率高于其他地方报道的情况，这需要进一步深入研究。
