Monitoring SCCA-IgM complexes in serum predicts liver disease progression in patients with chronic hepatitis.
About 30% of the patients with chronic hepatitis develop a progressive liver disease and one of the most intriguing issues is the detection of noninvasive markers for fibrosis stage and disease progression. High levels of squamous cell carcinoma antigen (SCCA)-immunoglobulin M (IgM) are detectable in hepatocellular carcinoma and their increase in cirrhotic patients can predict tumour development. As SCCA-IgM can also be detectable at low percentages in patients with chronic hepatitis, the aim of this study was to assess SCCA-IgM complexes in relation to disease outcome in this group of patients. An ELISA assay was used to determine the presence of SCCA-IgM in 188 patients with chronic hepatitis and in 100 controls. An additional serum sample was available after a median period of 6 years in 57 untreated patients: these patients were subdivided in group A, including eight patients with a fibrosis score increase > or =2 in a second liver biopsy and group B, including 49 patients without fibrosis progression during a similar follow up. SCCA-IgM complexes were detectable in 63 of 188 (33%) patients but in none of the controls. A significant increase of SCCA-IgM levels over time was observed in patients with fibrosis progression (mean +/- SD: 117 +/- 200 U/mL/year), but not in those without histologic deterioration (mean +/- SD: -8.8 +/- 31 U/mL/year, P < 0.0001). In conclusion, monitoring SCCA-IgM levels over time appears a useful approach to identify patients with chronic hepatitis at higher risk for cirrhosis development.
Biasiolo
A
A
Clinica Medica 5, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
Chemello
L
L
Quarta
S
S
Cavalletto
L
L
Bortolotti
F
F
Caberlotto
C
C
Beneduce
L
L
Bernardinello
E
E
Tono
N
N
Fassina
G
G
Gatta
A
A
Pontisso
P
P
D000328:Adult; D000936:Antigen-Antibody Complex / Q000097:blood*; D000951:Antigens, Neoplasm / Q000276:immunology*; D015415:Biomarkers; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006521:Hepatitis, Chronic / Q000150:complications* / Q000473:pathology; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015843:Serpins / Q000276:immunology*
D000936:Antigen-Antibody Complex; D000951:Antigens, Neoplasm; D015415:Biomarkers; D007075:Immunoglobulin M; D015843:Serpins; C051072:squamous cell carcinoma-related antigen