Role of Serum Squamous Cell Carcinoma Antigen-IgM in Response Assessment of Hepatocellular Carcinoma Radiofrequency Ablation

Abstract Background: Hepatocellular carcinoma (HCC), one of the main complications of liver cirrhosis, is one of the most common malignancies with high mortality rate requiring early diagnosis and treatment.Serum squamous cell carcinoma antigen-IgM (SCCA-IgM) can be distinguished in the serum of HCC patients and has been suggested to be a biomarker for its diagnosis and in assessment of radiofrequency ablation (RFA). Aim of Study: The aim of this study is to evaluate the value of SCCA-IgM in assessment of response to hepatocellular carcinoma thermal radiofrequency ablation. Subjects and Methods: Forty HCC patients and 15 patients with liver cirrhosisestimated clinically, laboratory and by abdominal ultrasound were enrolled. The patients were sub-divided into three subgroups as following: Group I: Twenty-five patients with HCC and alpha-fetoprotein (AFP) <200ng/ mL [HCC with low AFP]. Group II: Fifteen patients with HCC and AFP >200ng/ml [HCC with significant AFP]. Group III: fifteen patients with liver cirrhosis estimated clinically, laboratory and by abdominal ultrasound without HCC. Using a validated ELISA, AFP and SCCA-IgM were measured in all the studied subjects (Group I, II and III) and after 1 month after radiofrequency ablation of HCC patients (Group I & II). Results: SCCA-IgM was highly significant difference between the three groups of patients (p < 0.001) as well as there is a statistically highly significant was found between each group and other except the comparison between group I and II (p>0.05). Also, SCCA-IgM before and after RFA shows statistically highly significant decrease in HCC patients of both groups I and II (p < 0.001). In comparison between the HCC of patients' groups I (HCC with low AFP) and II (HCC with significant AFP) after RFA, the decrease in SCCA-IgM was statistically insignificant (p>0.05). The diagnostic per-formance of SCCA-IgM at a cut-off 40 AU/mL in HCC patients (GI and II) had sensitivity 95.5%, specificity 96%, AUC 0.997, PPV 96, NPV 97.5 and Accuracy 97 respectively.
Conclusion: SCCA-IgM assay could be helpful inresponse assessment of the efficacy of HCC radiofrequency ablation without difference in the outcome of HCC patients with low or high AFP.