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Digestive Diseases and Sciences

, Volume 40, Issue 12, pp 2587–2594 | Cite as

α-fetoprotein and p53 autoantibodies in patients with chronic hepatitis C

  • Jochen Readle
  • W. Kurt Roth
  • Gerhard Oremek
  • Wolfgang F. Caspary
  • Stefan Zeuzem
Liver: Infectious, Inflammatory, and Metabolic Disorders

Abstract

Hepatitis C virus infection is a common cause of chronic liver disease and hepatocellular carcinoma. Recently, mutations in the p53 tumor suppressor gene with generation of circulating autoantibodies to p53 protein have been detected in a significant proportion of patients with different malignancies. Using ELISA methods we assessed α-fetoprotein and anti-p53 as serological screening parameters for hepatocellular carcinoma in 147 consecutive patients with chronic hepatitis C. Liver cirrhosis was histologically diagnosed in 58 patients (39.5%) and a hepatocellular carcinoma confirmed in seven patients (4.8%). Serum α-fetoprotein was raised above 20 ng/ml in 26/147 patients and above 100 ng/ml in 5/147 patients. In 6/7 patients with hepatocellular carcinoma, α-fetoprotein was raised above 20 ng/ml, but only in 3/7 cases above 100 ng/ml, resulting in a sensitivity and specificity of 85.7% and 85.7% (α-fetoprotein>20 ng/ml) and 42.9% and 98.6% (α-fetoprotein>100 ng/ml), for the detection of hepatocellular carcinoma, respectively. Autoantibodies to p53 were detected in 3/7 patients with hepatocellular carcinoma, but in 0/140 patients without malignancy (sensitivity 42.9%, specificity 100%). Screening for hepatocellular carcinoma was improved by combining α-fetoprotein measurement (level>100 ng/ml) with detection for anti-p53 (sensitivity 71.4%, specificity 98.6%). In conclusion, the presence of anti-p53 was highly specific for malignancy and independent of α-fetoprotein status. Further studies including a larger number of patients with hepatitis C virus-related hepatocellular carcinoma are required to investigate whether serological testing for anti-p53 in combination with α-fetoprotein might improve the detection of hepatocellular carcinoma in high-risk patients with liver cirrhosis.

Key Words

Hepatitis C virus chronic hepatitis C hepatocellular carcinoma tumor screening α-fetoprotein anti-p53 autoantibodies 

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Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • Jochen Readle
    • 1
    • 2
  • W. Kurt Roth
    • 1
    • 2
  • Gerhard Oremek
    • 1
    • 2
  • Wolfgang F. Caspary
    • 1
    • 2
  • Stefan Zeuzem
    • 1
    • 2
  1. 1.Second Department of Medicine, Division of GastroenterologyJohann Wolfgang Goethe-UniversityFrankfurt/MainGermany
  2. 2.Chemotherapeutisches Forschungsinstitut Georg-Speyer-HausFrankfurt/MainGermany

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