在人類的諸多癌症中，常可見到p53基因的變化，導致p53蛋白的半生期延長，與免疫學上之變化，例如出現某些特定抗體結合位置之改變。這類突變之p53蛋白的蓄積將使其較易產生免疫性。因此許多腫瘤皆可偵測出對抗p53蛋白之抗體。截至目前，關於p53抗體在腎細胞癌病人中的盛行率與臨床預後之影響，尚無充足報告。在本研究中，我們檢驗了於臺大醫院(民國七十九年十二月至八十六年十二月)治療之八十六位腎細胞癌病人的術前血清，測量p53抗體含量。其中八十三位有病理學的確認。我們採用ELISA系統來檢定血清中的p53抗體。對照組包括了29位良性前列腺肥大病人，其PSA值皆小於4ng/ml。腎細胞癌組與對照組病人的平均年齡分別為59與63.2歲。測量結果，86位腎細胞癌病人中，有5人呈現陽性反應(5.8%)，而對照組全部都呈陰性。具有p53抗體的五人中，三位是第三期癌症，兩位是第二期。一位因多處轉移而於術後九個月死已；一位死於腦血管疾病；一位並未接受手術，死於敗血症；有兩位在追蹤長達61與78個月時仍無復發跡象。經過分析，年齡、性別、無疾病進展存活期與其他因子，與p53抗體的存在並無統計學上顯著相關。但p53抗體呈陽性者，其存活期有較短之傾向(p=0.093)。結論是p53抗體對診斷腎細胞癌的敏感度雖低，但卻具有100%的專一性；現階段將其用於診斷或追蹤腎細胞癌病人並不適宜。

Antibodies to p53 protein have been detected in association with various kinds of tumors, however, little is known about its prevalence rate and prognostic implications in patients with re-nal cell carcinoma(RCC). In this retrospective study we examined the preoperative serum levels of anti-p53 antibody in 86 patients with RCC treated in our hospital from December 1990 to December 1997. Pathological verifications of RCC were available in all but 3 cases. Serum levels were deter-mined using an enzyme-linked immunosorbant assay (ELISA) system. The control group included 29 benign prostatic hypertrophy (BPH) patients with prostate specific antigen (PSA) levels less than 4 ng/ml. The mean ages of the RCC group and the control group were 29 and 63.2 yr, re-spectively. Five of the 86 (5.8%) RCC serum samples were positive for anti-p53 antibodies, while no positives were detected among the control group. There is no statistically significant correlation between the presence of anti-p53 antibodies and any clinicopathological parameters, such as age, sex, overall survival, or progression-free survival. There was only a trend toward a poorer sur-vival in patients with positive anti-p53 antibodies (p=0.093) Although the sensitivity of the p53-antibody for RCC diagnosis in patients with renal tumors is low, the specificity is satisfactorily high. The incidence of serum anti-p53 antibody in RCC patients was low. A study with greater case numbers is needed before a substantial conclusion can be made. (J Urol R.O.C., 10:143-148,1999)