title: Squamous cell carcinoma antigen-IgM is associated with hepatocellular carcinoma in patients with cirrhosis: A prospective study.
abstract: BACKGROUND
  Squamous cell carcinoma antigen (SCCA)-IgM complex has been described as a promising tool to identify patients with progressive liver disease at higher risk of hepatocellular carcinoma (HCC) development in retrospective studies.
  
  
  OBJECTIVE
  To assess the clinical value of this biomarker in patients with cirrhosis in a prospective study.
  
  
  METHODS
  Patients with overt cirrhosis were prospectively evaluated at 6-month intervals for HCC development and decompensation with clinical examination, liver ultrasound, α-fetoprotein measurement. SCCA-IgM was measured in serum by immunoenzymatic assay. Median follow-up duration was 52 months (range 12-68 months).
  
  
  RESULTS
  70 patients (26% male; mean age 56±10 years) were enrolled. The main aetiological factors were alcohol (44%) and hepatitis C (34%). Baseline values of SCCA-IgM were significantly higher in patients who developed HCC. Positivity of the biomarker at baseline was associated with a significantly shorter HCC-free survival, while α-fetoprotein (cut off >20 ng/ml) was not significant. SCCA-IgM positivity and hepatitis C were significant prognostic factors for HCC development. The biomarker was not associated with the development of clinical complications of cirrhosis.
  
  
  CONCLUSIONS
  This prospective study demonstrates that in patients with cirrhosis SCCA-IgM is associated with HCC development and may be useful for clinical management of cirrhotic patients at higher risk of HCC development.
authors.affiliation: Department of Medicine, University of Padua, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Biasiolo
authors.affiliation: Department of Medicine, University of Padua, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Trotta
authors.affiliation: Department of Medicine, University of Padua, Italy.
authors.forename: Silvano
authors.initials: S
authors.lastname: Fasolato
authors.affiliation: Department of Medicine, University of Padua, Italy.
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Ruvoletto
authors.affiliation: Department of Medicine, University of Padua, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Martini
authors.affiliation: Xeptagen SpA, Marghera (VE), Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallotta
authors.affiliation: Xeptagen SpA, Marghera (VE), Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Fassina
authors.affiliation: Department of Medicine, University of Padua, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Angeli
authors.affiliation: Department of Medicine, University of Padua, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Gatta
authors.affiliation: Department of Medicine, University of Padua, Italy. Electronic address: patrizia@unipd.it.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pontisso
mesh_terms: D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000276:immunology*; D014408:Biomarkers, Tumor / Q000276:immunology* / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000276:immunology* / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology*; D008103:Liver Cirrhosis / Q000150:complications; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000276:immunology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015843:Serpins / Q000276:immunology*; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D007075:Immunoglobulin M; D015843:Serpins; D000509:alpha-Fetoproteins; C051072:squamous cell carcinoma-related antigen
keywords: Biomarker; Circulating immunocomplexes; Hepatocellular carcinoma