意大利Padova大學(xué)的一個研究組發(fā)現(xiàn)，通過對因丙肝病毒（HCV）感染引發(fā)的肝硬化患者進(jìn)行連續(xù)的鱗狀細(xì)胞癌抗原（SCCA）和免疫球蛋白IgM檢測,，可以確定出患者在來年患上肝細(xì)胞癌的可能性,。由于到目前為止,，還沒有血清生物標(biāo)記物用于癌變監(jiān)測，因此這一發(fā)現(xiàn)具有重要意義,。
每年,，大約有3％到4％的肝硬化患者患上原發(fā)性肝癌。那些腫瘤很小并容易通過手術(shù)切除或干擾的患者的預(yù)后最好,。這些患者通常是通過超聲波定期檢查來監(jiān)控的,。
SCCA是一種絲氨酸蛋白酶抑制劑，在肝癌組織中高度表達(dá),。目前,，意大利已經(jīng)開發(fā)出一種對SCCA和IgM進(jìn)行聯(lián)合分析的新血清酶免疫吸收劑檢測法。在8月15日的International Journal of Cancer雜志上,，Pontisso博士的研究組報道了SCCA-IgA水平在未接受治療的HCV肝硬化患者中隨時間變化的關(guān)系,。
研究人員對兩組患者進(jìn)行了研究：A組16名患者在四年內(nèi)發(fā)生了肝細(xì)胞癌；B組17名患者在四年內(nèi)沒有發(fā)生癌變,。兩組最初具有相似的臨床特征,，包括SCCA-IgM血清水平相似（267 vs 249U/mL）。
但是,，A組患者隨著時間的推移,，其SCCA-IgM水平顯著增加。記錄數(shù)據(jù)顯示,，A組75％的患者SCCA-IgM水平每年增加20U/mL,，而B組患者則只有6％的患者以此幅度增加,。SCCA-IgM水平在癌癥臨床診斷的至少1年前開始增加,。
Pontisso博士的研究組表示，這種潛伏階段可能成為研發(fā)新治療藥物和方法的一個窗口,。一旦這些發(fā)現(xiàn)在更大規(guī)模的研究中被證實,，那么監(jiān)控SCCA-IgM復(fù)合體隨時間的變化情況將可能成為肝硬化患者的一個有用的預(yù)后參數(shù)。
英文原文：
Biomarker predicts transition of cirrhosis to hepatocellular carcinoma
NEW YORK (Reuters Health) - Serial measurement of squamous cell carcinoma antigen (SCCA) complexed with IgM in patients with cirrhosis due to hepatitis C virus infection (HCV) may identify patients likely to develop hepatocellular carcinoma in the next year, an Italian research team has found. This finding may be of particular importance, because up until now there has been no serological biomarker for use in surveillance programs.
Approximately 3% to 4% of cirrhotic patients develop primary liver cancer every year, lead researcher Dr. Patrizia Pontisso, at the University of Padova, and associates note. The prognosis is best for patients whose tumors are small enough for surgical or ablative interventions. These patients are usually monitored over time with ultrasound follow-up.
SCCA, a serine protease inhibitor, is highly expressed in liver cancer tissue, and a new serologic enzyme-linked immunosorbent assay for SCCA complexed with IgM has been developed (Hepa-1C, Xeptagen SpA, Italy). In the International Journal of Cancer for August 15, Dr. Pontisso's group reports the association between SCCA-IgA levels over time among patients with untreated HCV cirrhosis.
Included were 16 patients who developed hepatocellular carcinoma during median follow-up of 4 years (group A) and 17 who remained cancer-free over the same period (group B). The two groups had similar clinical profiles at presentation, including comparable serum levels of SCCA-IgM (mean 267 versus 249 U/mL).
However, SCCA-IgM levels increased significantly more over time in group A patients. The researchers recorded an increase of > 20 U/mL/year in 75% of group A patients versus 6%of group B patients. SCCA-IgM levels started increasing at least 1 year before clinical diagnosis of cancer.
Dr. Pontisso's group writes: "This preclinical phase might become a suitable window to specifically address new potentially effective therapies." Once the findings are confirmed in larger studies, they add, "monitoring SCCA-IgM complexes' behavior over time could become a useful prognostic parameter in cirrhotic patients, to support clinical decisions."
