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Clinical applications of squamous cell carcinoma antigenimmunoglobulins M to monitor chronic hepatitis C

World Journal of Hepatology 2015年第29期7卷 2913-2919页

作者： andrea Martini andrea gallotta Patrizia Pontisso Giorgio Fassina Department of Medicine University of Padua Xeptagen S.p.A. VEGA Science Park

Hepatitis C virus(HCV) is the main cause of chronic liver disease and cirrhosis in Western countries. Over time, the majority of cirrhotic patients develop hepatocellular carcinoma(HCC), one of the most common fatal cancers worldwide- fourth for incidence rate. A high public health priority need is the development of biomarkers to screen for liver disease progression and for early diagnosis of HCC development, particularly in the high risk population represented by HCV-positive patients with cirrhosis. Several studies have shown that serological determination of a novel biomarker, squamous cell carcinoma antigen-immunoglobulins M(SCCA-Ig M), might be useful to identify patients with progressive liver disease. In the initial part of this review we summarize the main clinical studies that have investigated this new circulating biomarker on HCV-infected patients, providing evidence that in chronic hepatitis C SCCA-Ig M may be used to monitor progression of liver disease, and also to assess the virological response to antiviral treatment. In the last part of this review we address other, not less important, clinical applications of this biomarker in hepatology.

关键词： Hepatitis C virus Treatment Prognosis Squamous cell carcinoma antigen-immunoglobulins M Cirrhosis

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Serum SCCA-IgM as a predictor of hepatocellular carcinoma in patients with liver cirrhosis

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Open Journal of Gastroenterology 2012年第2期2卷 56-61页

作者： Daniela Buccione Gianluca Fatti andrea gallotta Elisabetta Loggi Roberto Di Donato Lilia Testa Carlo Saitta Valentina Santi Antonio Di Micoli Virginia Erroi Marta Frigerio Valentina Fazio Antonino Picciotto Alessandra Biasiolo Francoise Degos Patrizia Pontisso Giovanni Raimondo Franco Trevisani APHP Hopital Beaujon INSERM U 773 Clichy France Dipartimento di Medicina Clinica e Sperimentale “G. Patrassi” Università di Padova Padova Italia Dipartimento di Medicina Clinica Alma Mater Studiorum-Università di Bologna Bologna Italia Dipartimento di Medicina Interna Policlinico Universitario di Messina Messina Italia Dipartimento di Medicina Interna Università di Genova Genova Italia Xeptagen S.p.A. Venezia Italia

Aberrant Squamous Cell Carcinoma Antigen (SCCA) expression is an early hepatocarcinogenetic event and circulating SCCA-IgM complexes are elevated in most HCC patients. We evaluated whether serum SCCA-IgM levels can identify HCV +ve cirrhotic patients at low HCC risk. In this retrospective study we enrolled 29 cirrhotic patients in whom serum SCCA-IgM was measured 8 - 69 months (median 31) before HCC diagnosis, and 28 cirrhotic patients who remained HCC- free, with SCCA-IgM measured 15 - 68 months (median 48) before the study end. The best discriminating value of SCCA-IgM was calculated and tested in predicting HCC diagnosis within 12, 24 and 36 months. Sensitivity analysis, considering different HCC incidence, was conducted to identify the patient subgroup with an annual cancer risk below the threshold of a cost-effective semiannual surveillance with ultrasound. Cumulative HCC incidence at 12, 24 and 36 months was 7.0%, 15.7% and 26.3%, respectively. SCCA-IgM levels were higher in HCC than in cirrhotic patients [median: 381 (95% C.I.: 50 - 5289) vs. 100 (70 - 493) AU/mL, P = 0.005]. The SCCA-IgM value ≤ 200 AU/mL accurately identified patients at low risk of HCC development in the subsequent year (sensitivity 75%, specificity 62%, positive predictive value 13% and negative predictive value 97%). Considering an annual HCC incidence ≤ 3%, patients with SCCA-IgM ≤ 200 AU/mL (60% of the whole patients) had an HCC risk below the accepted threshold of a cost-effective surveillance (1.5%). In conclusion, provided that our provocative results are confirmed in larger studies, SCCA-IgM serum measurement could permit implementation of a two step (with different costs) surveillance: an initial serological surveillance, based on the annual monitoring of this biomarker, and the conventional surveillance by semiannual US when SCCA-IgM becomes >200 AU/mL. This could improve the cost/effectiveness of surveillance of HCV infected patients at risk of HCC.

关键词： SCCA-IgM HCC Risk Assessment Surveillance Cost/Effectiveness

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Physical exercise intensity prescription to improve health and fitness in overweight and obese subjects: A review of the literature

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Health 2013年第6期5卷 113-121页

作者： Gian Pietro Emerenziani Silvia Migliaccio Maria Chiara gallotta andrea Lenzi Carlo Baldari Laura Guidetti Department of Experimental Medicine University of Rome “La Sapienza” Rome Italy Department of Movement Human and Health Sciences University of Rome “Foro Italico” Rome Italy

Obesity is one of the greatest public health challenges of the 21st century. Overweight and obesity drastically increase a person’s risk of developing chronic non-communicable diseases (NCDs), including cardiovascular disease, cancer and diabetes. Furthermore, obesity is already responsible for 2% -8% of health costs and 10% -13% of deaths in several industrialized countries. Lifestyle modifications involving changes in exercise, diet and psychological support are effective in reducing the incidence of overweight. Moreover, positive effects of physical activity (PA) for weight loss and prevention of weight regain are well documented. It was recognized that health benefits regarding both psychological and physiological aspects, such as improving cardiorespiratory and muscular fitness and/or decreasing depression symptoms, can be obtained from numerous activities. Public health institutions (American College of Sports Medicine, World Health Organization) provide recommendations for PA (volume, frequency, intensity and type of exercise) to achieve positive effects, at all ages and for many diseases and disorders situations. Although exercise under guidelines can be safely performed by obese subjects, several questions still need to be fully answered. In facts, the exercise program should be tailored according to an individual’s habitual physical activity, physical function, health status, exercise responses, and stated goals. Thus, this review analyzes the intensity of PA parameters. In the last years, research has been focused on the individualization of the right intensity in which different types of subjects’ condition must undergo to achieve the health goals. Aerobic exercise has been commonly used to reach weight loss goal. Prescription of aerobic exercise in clinical practice is frequently based on the percentage of maximum heart rate (%HRmax), heart rate reserve (%HRreserve), rating of perceived exertion (RPE), maximal oxygen consumption (%VO2max) and for unheal

关键词： Obesity Overweight Exercise Intensity Prescription Gas Exchange Thresholds Health

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