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Abstract
HCC is the predominant form of primary malignancy of the liver.In many parts of the world including Egypt, it is among the leading causes of cancer-related mortality.Despite knowing the high-risk populations for HCC development,the lack of sensitive and specific biomarkers hinders early detection of the disease at a curable stage.Therefore,the identification of new diagnostic markers for HCC becomes a top priority.The aim of this study was to evaluate the potential role of circulating activin A and its binding protein, follistatin as well as MAGE-1 and MAGE-3 gene transcripts in the peripheral blood and tumor tissue in the diagnosis and progression of HCC. In order to achieve this goal, thirty patients with liver cirrhosis were included in the study and were divided into two groups; Group I consisted of 15 patients with untreated HCC and Group II consisted of 15 patients without evidence of HCC.The diagnosis of HCC was based on serum levels of AFP, ultrasonography and triphasic CT and was confirmed by histopathological examination.The study also included 15 healthy subjects as controls (Group III).All cirrhotic patients had thorough clinical evaluation focusing on symptoms and signs of chronic liver disease [previous upper GI bleeding, jaundice, ascites, hepatic encephalopathy and bleeding diathesis], presence of palpable focal hepatic lesions, liver size and spleen size. Abdominal ultrasonographic examination was performed to assess the presence of liver cirrhosis,splenomegaly and ascites and characteristics of HCC including maximunm diameter, number of nodules, location, presence of capsule, portal vein thrombosis, and intrahepatic metastasis.The severity of liver disease was graded as class A,B and C according to Child-Pugh classification. The HCC stage was assessed as Stage 0-6 using numerical scoring system of the CLIP classification .