Beneduce L, Pesce G, Gallotta A, Zampieri F, Biasiolo A, Tono N, Boscato N, Gatta A, Pontisso P, Fassina G
XEPTAGEN SpA, Marghera Venezia, Italy.
Eur J Clin Invest. 2008 Aug;38(8):571-7. doi: 10.1111/j.1365-2362.2008.01985.x.
In the sera of liver, colorectal and prostate cancer patients, several biomarkers may be detected as IgM immune complexes. To determine whether the presence of immune complexes was correlated to an increase of IgMs, we measured the IgM content in the sera of patients with hepatocellular carcinoma (HCC) and cirrhosis, and evaluated the occurrence of des-gamma-carboxy prothrombin (DCP) as immune complexes (DCP-IgM) compared to the levels of DCP and alpha-fetoprotein (AFP).
Serum samples from 31 patients with cirrhosis, 33 untreated HCC patients diagnosed by ultrasound, computed tomography and/or magnetic resonance and confirmed by histopathology, when indicated, and 30 healthy controls were analysed. Concentrations of IgM and DCP-IgM were determined by ELISAs.
Circulating IgM in patients with HCC (median level = 1.79 mg mL(-1)) and cirrhosis (1.09 mg mL(-1)) were not significantly different (P = 0.1376) while DCP-IgM were significantly higher in HCC patients (median level = 2171.2 AU mL(-1)) than in those with cirrhosis (1152 AU mL(-1), P = 0.0047). No correlation was found between DCP-IgM and IgM in HCC (r = 0.227) and cirrhosis patients (r = 0.475). DPC-IgM was positive in 55% (18/33) of HCC patients and in 26% (8/31) of cirrhosis patients compared to 39% and 26% for DCP and 48% and 13% for AFP. DCP-IgM, DCP and AFP tests had 100% specificity in healthy controls.
DCP-IgM in HCC patients was not associated with an increase in IgM concentration. DCP-IgM was more frequently detected in HCC patients than DCP and AFP, strengthening the diagnostic role of IgM immune complexes for liver cancer.
在肝癌、结直肠癌和前列腺癌患者的血清中，可检测到几种作为IgM免疫复合物的生物标志物。为了确定免疫复合物的存在是否与IgM的增加相关，我们检测了肝细胞癌（HCC）和肝硬化患者血清中的IgM含量，并评估了与脱γ-羧基凝血酶原（DCP）和甲胎蛋白（AFP）水平相比，作为免疫复合物（DCP-IgM）的脱γ-羧基凝血酶原的出现情况。
分析了31例肝硬化患者、33例经超声、计算机断层扫描和/或磁共振诊断并经组织病理学确诊（如有需要）的未经治疗的HCC患者以及30名健康对照者的血清样本。通过酶联免疫吸附测定法（ELISA）测定IgM和DCP-IgM的浓度。
HCC患者（中位水平 = 1.79 mg mL⁻¹）和肝硬化患者（1.09 mg mL⁻¹）的循环IgM无显著差异（P = 0.1376），而HCC患者的DCP-IgM（中位水平 = 2171.2 AU mL⁻¹）显著高于肝硬化患者（1152 AU mL⁻¹，P = 0.0047）。在HCC患者（r = 0.227）和肝硬化患者（r = 0.475）中，未发现DCP-IgM与IgM之间存在相关性。与DCP的39%和26%以及AFP的48%和13%相比，55%（18/33）的HCC患者和26%（8/31）的肝硬化患者DPC-IgM呈阳性。DCP-IgM、DCP和AFP检测在健康对照者中的特异性均为100%。
HCC患者的DCP-IgM与IgM浓度的增加无关。与DCP和AFP相比，HCC患者中更频繁地检测到DCP-IgM，这强化了IgM免疫复合物对肝癌的诊断作用。
