Clinical

Biomarker predicts transition of cirrhosis to hepatocellular carcinoma

Last Updated: 2006-07-31 16:48:27 -0400 (Reuters Health)

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."

Int J Cancer 2006;119:735-740.