Guarino Maria, Di Costanzo Giovan G, Gallotta Andrea, Tortora Raffaella, Paneghetti Laura, Auriemma Francesco, Tuccillo Concetta, Fassina Giorgio, Caporaso Nicola, Morisco Filomena
a Department of Clinical Medicine and Surgery, Gastroenterology Unit , University of Naples Federico II , Naples , Italy.
b Liver Unit , ' A.Cardarelli' Hospital , Naples , Italy.
Scand J Clin Lab Invest. 2017 Oct;77(6):448-453. doi: 10.1080/00365513.2017.1336569. Epub 2017 Jun 13.
Hepatocellular carcinoma (HCC) develops in about 3-4% of cirrhotic patients every year. The squamous cell carcinoma antigen (SCCA) has been found elevated in liver cancer specimens by immunohistochemistry, and detected in complex with IgM (SCCA-IgM) in the serum of patients with HCC. The aim of this study was to evaluate the ability of serological SCCA-IgM levels to predict the efficacy of HCC therapy.
From April 2012 to April 2014, 131 patients with a new diagnosis of HCC were enrolled. The HCC diagnosis was made according to the EASL guidelines. The patients were staged and treated according to the BCLC Staging System: BCLC stages A and B were treated with locoregional therapy, and BCLC stage C was treated with Sorafenib. Response to therapy was evaluated according to the mRECIST criteria. Serum SCCA-IgM levels were determined by a commercially available ELISA kit at basal time (T) and after one month of treatment (T).
At baseline and one month into therapy, SCCA-IgM levels were significantly lower (p value <.05) in patients who responded to therapy compared to those who did not respond (median SCCA-IgM level [25th + 75th percentile] at T:115.1 AU/mL [50.0 + 174.4] vs. 149.1 AU/mL [111.3 + 198.8]; median SCCA-IgM level [25th + 75th percentile] at T: 113.4 AU/mL [50.0 + 194.2] vs. 170.6 AU/mL [111.7 + 344.2]).
Our study suggests that the SCCA-IgM determination could be helpful in predicting the response to therapy in patients with HCC.
每年约3%-4%的肝硬化患者会发展为肝细胞癌（HCC）。通过免疫组织化学发现肝癌标本中鳞状细胞癌抗原（SCCA）升高，并在HCC患者血清中检测到其与IgM形成的复合物（SCCA-IgM）。本研究的目的是评估血清SCCA-IgM水平预测HCC治疗疗效的能力。
2012年4月至2014年4月，纳入131例新诊断为HCC的患者。HCC诊断依据欧洲肝脏研究学会（EASL）指南。患者根据巴塞罗那临床肝癌（BCLC）分期系统进行分期和治疗：BCLC A期和B期采用局部区域治疗，BCLC C期采用索拉非尼治疗。根据改良实体瘤疗效评价标准（mRECIST）评估治疗反应。在基线期（T0）和治疗1个月后（T1），使用市售酶联免疫吸附测定（ELISA）试剂盒测定血清SCCA-IgM水平。
在基线期和治疗1个月时，与无反应患者相比，有反应患者的SCCA-IgM水平显著降低（p值<.05）（T0时SCCA-IgM水平中位数[第25百分位数+第75百分位数]：115.1 AU/mL[50.0 + 174.4] vs. 149.1 AU/mL[111.3 + 198.8]；T1时SCCA-IgM水平中位数[第25百分位数+第75百分位数]：113.4 AU/mL[50.0 + 194.2] vs. 170.6 AU/mL[111.7 + 344.2]）。
我们的研究表明，测定SCCA-IgM有助于预测HCC患者的治疗反应。
