Department of Medicine, University of Padua, Padua, Italy.
Xeptagen S.p.A., Venice, Italy.
Sci Rep. 2019 Dec 27;9(1):20126. doi: 10.1038/s41598-019-56633-2.
Complications of chronic liver diseases - particularly hepatocellular carcinoma (HCC) - are a major cause of mortality worldwide. Several studies have shown that high or increasing levels of serum Squamous Cell Carcinoma Antigen-Immunoglobulin M complex (SCCA-IgM) are associated with development of HCC in patients with advanced liver disease and worse survival in patients with liver cancer. The aim of the present study was to assess, in patients with advanced liver disease, differences in long-term clinical outcomes in relation to baseline levels of serum SCCA-IgM. Ninety one consecutive outpatients with liver cirrhosis of different etiologies, without hepatocellular carcinoma at presentation, were enrolled from April 2007 to October 2012 in a prospective study. For a median time of 127 months, patients were bi-annually re-evaluated. SCCA-IgM complex levels were determined with a validated enzyme-linked immunosorbent assay. The results provided evidence that serum SCCA-IgM is a predictor of overall survival. The best cut-off to discriminate both HCC-free and overall survival rates was 120 AU/mL. Patients with baseline values higher than this threshold showed a substantial increase in both HCC incidence rate and all-cause mortality rate. In conclusion, a single measurement of serum SCCA-IgM helps to identify those patients with liver cirrhosis with increased risks of HCC development and mortality.
慢性肝脏疾病的并发症——尤其是肝细胞癌（HCC）——是全球范围内导致死亡的主要原因。多项研究表明，血清鳞状细胞癌抗原免疫球蛋白 M 复合物（SCCA-IgM）水平升高或持续升高与晚期肝病患者 HCC 的发生发展有关，且此类患者的生存率较差。本研究旨在评估血清 SCCA-IgM 基线水平与晚期肝病患者长期临床结局的关系。2007 年 4 月至 2012 年 10 月，连续纳入 91 例无 HCC 初诊的不同病因肝硬化门诊患者，进行前瞻性研究。中位随访时间为 127 个月，患者每半年进行一次复查。采用经过验证的酶联免疫吸附试验检测 SCCA-IgM 复合物水平。结果表明，血清 SCCA-IgM 是总生存率的预测因子。最佳截断值为 120 AU/mL，可区分 HCC 无复发生存率和总生存率。基线值高于该阈值的患者 HCC 发生率和全因死亡率均显著增加。总之，单次检测血清 SCCA-IgM 有助于识别肝硬化患者 HCC 发生和死亡风险增加。
