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Open Access Research article

Prognostic significance of anti-p53 and anti-KRas circulating antibodies in esophageal cancer patients treated with chemoradiotherapy

Pierre Blanchard12, Laurent Quero1, Vincent Pacault1, Marie-Helene Schlageter3, Valerie Baruch-Hennequin1 and Christophe Hennequin14*

Author affiliations

1 Radiation Oncology Department, Hôpital Saint Louis, AP-HP, Paris, France

2 Radiation Oncology Department, Institut Gustave Roussy, Villejuif, France

3 Unité de Biologie Cellulaire, Hôpital Saint Louis, AP-HP, Paris, France

4 Radiation Oncology Department, Hôpital Saint Louis, 1, Avenue Claude Vellefaux, Paris 75010, France

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Citation and License

BMC Cancer 2012, 12:119  doi:10.1186/1471-2407-12-119

Published: 26 March 2012

Abstract

Background

P53 mutations are an adverse prognostic factor in esophageal cancer. P53 and KRas mutations are involved in chemo-radioresistance. Circulating anti-p53 or anti-KRas antibodies are associated with gene mutations. We studied whether anti-p53 or anti-KRas auto-antibodies were prognostic factors for response to chemoradiotherapy (CRT) or survival in esophageal carcinoma.

Methods

Serum p53 and KRas antibodies (abs) were measured using an ELISA method in 97 consecutive patients treated at Saint Louis University Hospital between 1999 and 2002 with CRT for esophageal carcinoma (squamous cell carcinoma (SCCE) 57 patients, adenocarcinoma (ACE) 27 patients). Patient and tumor characteristics, response to treatment and the follow-up status of 84 patients were retrospectively collected. The association between antibodies and patient characteristics was studied. Univariate and multivariate survival analyses were conducted.

Results

Twenty-four patients (28%) had anti-p53 abs. Abs were found predominantly in SCCE (p = 0.003). Anti-p53 abs were associated with a shorter overall survival in the univariate analysis (HR 1.8 [1.03-2.9], p = 0.04). In the multivariate analysis, independent prognostic factors for overall and progression-free survival were an objective response to CRT, the CRT strategy (alone or combined with surgery [preoperative]) and anti-p53 abs. None of the long-term survivors had p53 abs. KRas abs were found in 19 patients (23%, no difference according to the histological type). There was no significant association between anti-KRas abs and survival neither in the univariate nor in the multivariate analysis. Neither anti-p53 nor anti-KRas abs were associated with response to CRT.

Conclusions

Anti-p53 abs are an independent prognostic factor for esophageal cancer patients treated with CRT. Individualized therapeutic approaches should be evaluated in this population.

Keywords:
Esophageal cancer; Radiotherapy; Chemotherapy; p53; Ras