dc.creator | Gil Gómez, Antonio | es |
dc.creator | Rojas, Ángela | es |
dc.creator | Gallego Durán, Rocío | es |
dc.creator | Ampuero Herrojo, Javier | es |
dc.creator | Romero Gómez, Manuel | es |
dc.creator | Pontisso, Patrizia | es |
dc.creator | Liu, Changhai | es |
dc.date.accessioned | 2022-09-09T16:27:11Z | |
dc.date.available | 2022-09-09T16:27:11Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Gil Gómez, A., Rojas, Á., Gallego-Durán, R., Ampuero Herrojo, J., Romero Gómez, M., Pontisso, P. y Liu, C. (2021). Combination of squamous cell carcinoma antigen immunocomplex and alpha-fetoprotein in mid- and long-term prediction of hepatocellular carcinoma among cirrhotic patients. WORLD JOURNAL OF GASTROENTEROLOGY, 27 (48), 8343-8356. | |
dc.identifier.issn | 1007-9327 | es |
dc.identifier.issn | 2219-2840 | es |
dc.identifier.uri | https://hdl.handle.net/11441/136956 | |
dc.description.abstract | BACKGROUND
The combination of alpha-fetoprotein (AFP) and squamous cell carcinoma antigen
immunocomplex (SCCA-IgM) have been proposed for its use in the screening of
hepatocellular carcinoma (HCC). Current screening programs for all cirrhotic
patients are controversial and a personalized screening is an unmet need in the
precision medicine era.
AIM
To determine the role of the combination of SCCA-IgM and AFP in predicting
mid- and long-term appearance of HCC.
METHODS
Two-hundred and three cirrhotic patients (Child A 74.9%, B 21.2%, C 3.9%) were
followed-up prospectively every six months to screen HCC by ultrasound and
AFP according to European Association for the Study of the Liver guidelines. The
estimation cohort was recruited in Italy (30.5%; 62/203) and validation cohort
from Spain (69.5%; 141/203). Patients underwent to evaluate SCCA-IgM by
enzyme-linked immunosorbent assay (Hepa-IC, Xeptagen, Italy) and AFP levels
at baseline. Patients were followed-up for 60 mo, being censored at the time of the
appearance of HCC.
RESULTS
There were 10.8% and 23.1% of HCC development at two- and five-years follow up. Patients with HCC showed higher levels of SCCA-IgM than those without it
(425.72 ± 568.33 AU/mL vs 195.93 ± 188.40 AU/mL, P = 0.009) during the five year follow-up. In multivariate analysis, after adjusting by age, sex, aspartate
transaminase and Child-Pugh, the following factors were independently
associated with HCC: SCCA-IgM [Hazard ratio (HR) = 1.001, 95%CI: 1.000-1.002;
P = 0.003], AFP (HR = 1.028, 95%CI: 1.009-1.046; P = 0.003) and creatinine (HR =
1.564 95%CI: 1.151-2.124; P = 0.004). The log-rank test of the combination resulted
in 7.488 (P = 0.024) in estimation cohort and 11.061 (P = 0.004) in the validation
cohort, and a 100% of correctly classified rate identifying a low-risk group in both
cohorts in the two-year follow-up.
CONCLUSION
We have constructed a predictive model based on the combination of SCCA-IgM
and AFP that provides a new HCC screening method, which could be followed by
tailored HCC surveillance for individual patients, especially for those cirrhotic
patients belonging to the subgroup identified as low-risk of HCC development. | es |
dc.format | application/pdf | es |
dc.format.extent | 19 p. | es |
dc.language.iso | eng | es |
dc.publisher | BAISHIDENG PUBLISHING GROUP INC | es |
dc.relation.ispartof | WORLD JOURNAL OF GASTROENTEROLOGY, 27 (48), 8343-8356. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Squamous Cell Carcinoma Antigen | es |
dc.subject | Hepatocellular Carcinoma Prediction | es |
dc.subject | Precision Medicine | es |
dc.subject | Stratification of Cirrhotic Patient | es |
dc.title | Combination of squamous cell carcinoma antigen immunocomplex and alpha-fetoprotein in mid- and long-term prediction of hepatocellular carcinoma among cirrhotic patients | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina | es |
dc.relation.publisherversion | https://www.wjgnet.com/1007-9327/full/v27/i48/8343.htm | es |
dc.identifier.doi | 10.3748/wjg.v27.i48.8343 | es |
dc.journaltitle | WORLD JOURNAL OF GASTROENTEROLOGY | es |
dc.publication.volumen | 27 | es |
dc.publication.issue | 48 | es |
dc.publication.initialPage | 8343 | es |
dc.publication.endPage | 8356 | es |