Background: Aberrant squamous cell carcinoma antigen (SCCA) expression is an early event in hepatocarcinogenesis, and increasing serum levels of SCCA variants IgM immune complexes (SCCA-IgM IC) have been found in cirrhotic patients developing hepatocellular carcinoma (HCC). As SCCA-IgM can also be detectable at low percentages 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. Aims: We wanted to see if patients with compensated cirrhosis treated with peg-interferon and ribavirin, responders to treatment, result in a reduction of fibrosis and serum levels of SCCA-IgM complexes. Methods: We longitudinally evaluated a cohort of cirrhotic patients with hepatitis C virus infection (HCV) who underwent pegylated interferon (PEG-IFN) and ribavirin treatment. SCCA-IgM IC levels were assessed in the sera of 13 cirrhotic patients with HCV (8 males and 5 females median age 58 years) before, at the end and at 6-month and 1-year follow-up after treatment with Peg-IFN and Ribavirin. An ELISA assay (Hepa-IC XG003 XEPTAGEN) was used to determine the presence of SCCA-IgM complexes. SCCA-IgM IC serum levels (arbitrary units/mL, AU/mL) were evaluated according to treatment outcome: sustained virological response (SVR) vs non-response (NR). Results: Overall, 6 patients obtained a SVR to antiviral therapy (46%). There was no significant difference in baseline SCCA-IgM IC serum levels between SVR and NR patients. When compared to baseline (252.2 AU/mL), SVR patients showed a significant decrease in median SCCA-IgM IC serum levels at the end of treatment (156.8 AU/mL, P = 0.013) and at both 6-month (76.8 AU/mL, P < 0.001) and 1-year follow-up (42.4 AU/mL, P < 0.001), while no significant modification was observed in NR patients. Conclusions: In patients with HCV-related liver cirrhosis, successful antiviral therapy is associated with a significant decrease in SCCA-IC serum levels. Because of the pathophysiological correlation between SCCA and liver carcinogenesis, it is hypothesized that in patients with liver cirrhosis, SVR may be accompanied by a decreased proliferative stimulation.
Combination therapy with pegylated-Interferon and Ribavirin determines a decrease in Squamous Cell Carcinoma Antigen (SCCA)-Immunoglobulin M (IgM) complex (SCCA-IgM IC) serum levels in patients with HCV-related liver cirrhosis
BERTINO, Gaetano;CAMPAGNA D;NERI, Sergio
2010-01-01
Abstract
Background: Aberrant squamous cell carcinoma antigen (SCCA) expression is an early event in hepatocarcinogenesis, and increasing serum levels of SCCA variants IgM immune complexes (SCCA-IgM IC) have been found in cirrhotic patients developing hepatocellular carcinoma (HCC). As SCCA-IgM can also be detectable at low percentages 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. Aims: We wanted to see if patients with compensated cirrhosis treated with peg-interferon and ribavirin, responders to treatment, result in a reduction of fibrosis and serum levels of SCCA-IgM complexes. Methods: We longitudinally evaluated a cohort of cirrhotic patients with hepatitis C virus infection (HCV) who underwent pegylated interferon (PEG-IFN) and ribavirin treatment. SCCA-IgM IC levels were assessed in the sera of 13 cirrhotic patients with HCV (8 males and 5 females median age 58 years) before, at the end and at 6-month and 1-year follow-up after treatment with Peg-IFN and Ribavirin. An ELISA assay (Hepa-IC XG003 XEPTAGEN) was used to determine the presence of SCCA-IgM complexes. SCCA-IgM IC serum levels (arbitrary units/mL, AU/mL) were evaluated according to treatment outcome: sustained virological response (SVR) vs non-response (NR). Results: Overall, 6 patients obtained a SVR to antiviral therapy (46%). There was no significant difference in baseline SCCA-IgM IC serum levels between SVR and NR patients. When compared to baseline (252.2 AU/mL), SVR patients showed a significant decrease in median SCCA-IgM IC serum levels at the end of treatment (156.8 AU/mL, P = 0.013) and at both 6-month (76.8 AU/mL, P < 0.001) and 1-year follow-up (42.4 AU/mL, P < 0.001), while no significant modification was observed in NR patients. Conclusions: In patients with HCV-related liver cirrhosis, successful antiviral therapy is associated with a significant decrease in SCCA-IC serum levels. Because of the pathophysiological correlation between SCCA and liver carcinogenesis, it is hypothesized that in patients with liver cirrhosis, SVR may be accompanied by a decreased proliferative stimulation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
