Clinical significance of ascitic p53 autoantibodies as a prognostic factor in patients with epithelial ovarian carcinoma

Ku, In Sang; Koo, Mi Kyung; Kang, Jung Kweon; Lee, Young Me; Kim, Kyung Tai; Cho, Sam Hyun; Hwang, Youn Yeung

Abstract

OBJECTIVES
A study was to assess the prognostic significance of ascitic anti-p53 autoantibodies in patients with advanced ovarian carcinoma.
METHODS
Retrospective study was peformed in 43 ovarian carcinoma patients who presented with a significant amount of ascites at the Department of Obstetrics and Gynecology in Hanyang University Hospital between 1991 to 2000. p53 autoantibodies were determined by highly specific enzyme-linked immunosorbant assay (p53-Autoantibody ELISAplus, CAT QI A53, A CN Bioscience Company, Boston). The 'positive' and 'negative' group were categorized on the basis of the presence of anti-p53 autoantibodies. The clinicopathologic characteristics, disease free survival and overall survival rate in each groups were compared. Statistical analysis was performed by X2 and independent sample t-test. RESULT: Ascitic anti-p53 autoantibodies were found in 16% (7/43) of the study patients. The positive rates were revealed as follows : serous 15% (2/13), mucinous 11% (2/17), undifferentiated, 42% (3/7) in histologic type ; stage I/II5% (1/21), III/IV 27% (6/16); grade I/II12% (3/26), III 24% (4/17). There was no correlation between clinicopathologic characteristics and the presence of ascitic anti-p53 autoantibodies except the stage of disease. The overall survival rate revealed no significant statistical meaning (20.0 vs 35.7 months, p=0.492). In contrast, disease free survival rate was decreased in positive group. (10.0 vs 24.7 months, p=0.032). A significance association was observed between presence of ascitic anti-p53 autoantibody and response to chemotherapy. Ascitic anti-p53 autoantibodies were detected in only 3 (16%) of 18 patients who achieved pathological partial and complete response, but it was detected in 3 (75%) of 4 patients who did not respond to chemotherapy (p=0.046).
CONCLUSION
The presence of p53 autoantibodies in ascites is tend to be associated with advanced stage and poorly differentiated group. A significant correlation was observed between presence of ascitic p53 autoantibodies and decrease in disease free survival rate suggesting that it is related to poor prognosis. Moreover, presence of ascitic p53 autoantibodies was also related to chemoresistance. But since this study is retrospective and based on very limited case, further study is warranted to be performed prospectively and based on larger number of study group.