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

  • Liver: Infectious, Inflammatory, and Metabolic Disorders
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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.

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Authors and Affiliations

  1. Second Department of Medicine, Division of Gastroenterology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany

    Jochen Readle MD, W. Kurt Roth MD, Gerhard Oremek PhD, Wolfgang F. Caspary MD &  Stefan Zeuzem MD

  2. Chemotherapeutisches Forschungsinstitut Georg-Speyer-Haus, Frankfurt/Main, Germany

    Jochen Readle MD, W. Kurt Roth MD, Gerhard Oremek PhD, Wolfgang F. Caspary MD &  Stefan Zeuzem MD

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  1. Jochen Readle MD
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Readle, J., Roth, W.K., Oremek, G. et al. α-fetoprotein and p53 autoantibodies in patients with chronic hepatitis C. Digest Dis Sci 40, 2587–2594 (1995). https://doi.org/10.1007/BF02220446

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  • DOI: https://doi.org/10.1007/BF02220446

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