title: Tumour-associated antigens in systemic sclerosis patients with interstitial lung disease: association with lung involvement and cancer risk.
abstract: OBJECTIVE
  To evaluate the serum levels of tumour-associated antigens (TAAs) in patients with SSc and interstitial lung disease (ILD) and to define whether their levels mirror the severity and the progression of lung damage.
  
  
  METHODS
  Data from 80 SSc patients with ILD were collected at baseline and after 2 years as well as from 40 SSc controls without ILD. The occurrence of any malignancy was recorded.
  
  
  RESULTS
  At baseline, an increase of at least one TAA was present in 35 SSc patients with ILD compared with 6 SSc patients without ILD (P < 0.0001); this was associated with lower forced vital capacity (FVC) and higher interstitial and alveolar scores. Levels of carbohydrate antigen 15-3 and carcinoembryonic antigen inversely correlated with FVC and directly correlated with alveolar and interstitial scores and their levels were higher in patients who presented a progression of lung damage after 2 years. During 4 years of follow-up, a malignancy was detected in seven patients who already had an increase of at least one TAA. Values of TAAs increased over time in patients who developed cancer, while their trend remained stable in the others. At multivariate analysis, to have three or more TAAs emerged as a strong independent predictor of the development of malignancies [relative risk 24.1 (95% CI 1.8, 315.0), P = 0.02].
  
  
  CONCLUSIONS
  TAAs can be elevated in the sera of SSc patients and correlate with the degree of lung damage, suggesting a role as severity biomarkers. Close follow-up is necessary in SSc patients because of the increased cancer risk overall in patients with increased TAAs.
authors.affiliation: Institute of Rheumatology and Affine Sciences, Department of Rheumatology.
authors.forename: Giacomo
authors.initials: G
authors.lastname: De Luca
authors.affiliation: Institute of Rheumatology and Affine Sciences, Department of Rheumatology.
authors.forename: Silvia L
authors.initials: SL
authors.lastname: Bosello
authors.affiliation: Institute of Rheumatology and Affine Sciences, Department of Rheumatology.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Berardi
authors.affiliation: Institute of Rheumatology and Affine Sciences, Department of Rheumatology.
authors.forename: Manuela
authors.initials: M
authors.lastname: Rucco
authors.affiliation: Institute of Rheumatology and Affine Sciences, Department of Rheumatology.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Canestrari
authors.affiliation: Institute of Rheumatology and Affine Sciences, Department of Rheumatology.
authors.forename: Miriam
authors.initials: M
authors.lastname: Correra
authors.affiliation: Institute of Rheumatology and Affine Sciences, Department of Rheumatology.
authors.forename: Luisa
authors.initials: L
authors.lastname: Mirone
authors.affiliation: Institute of Biochemistry and.
authors.forename: Franca
authors.initials: F
authors.lastname: Forni
authors.affiliation: Institute of Rheumatology and Affine Sciences, Department of Rheumatology, Institute of Biochemistry and.
authors.forename: Clara
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: Department of Bioimaging and Radiological Sciences, Catholic University, Rome, Italy.
authors.forename: Francesco M
authors.initials: FM
authors.lastname: Danza
authors.affiliation: Department of Bioimaging and Radiological Sciences, Catholic University, Rome, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Pirronti
authors.affiliation: Institute of Rheumatology and Affine Sciences, Department of Rheumatology, gf.ferraccioli@rm.unicatt.it.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Ferraccioli
mesh_terms: D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D016022:Case-Control Studies; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008168:Lung / Q000473:pathology* / Q000503:physiopathology; D017563:Lung Diseases, Interstitial / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D012720:Severity of Illness Index; D014797:Vital Capacity / Q000502:physiology
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D015415:Biomarkers; D002272:Carcinoembryonic Antigen
keywords: cancer; lung involvement; neoplasia; systemic sclerosis; tumour-associated antigens