الفهرس 
HEPATOCELLULAR CARCINOMAOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is one of the most deadly malignancies worldwide HCC, the major type of liver cancer, is the fifth most frequent neoplasm and the third most common cause of cancer-related death in the world. HCC incidence has doubled in Egypt in the past 10 years, which could be attributed to the high prevalence of hepatitis C virus (HCV) and hepatitis B virus (HBV).
The prognosis of patients with HCC remains extremely poor. Treatment of HCC presents a significant challenge because detection of such tumors usually occurs at advanced stage or after metastasis so early detection is the best choice. Current diagnosis of HCC relies on clinical information, liver imaging and measurement of serum alpha-fetoprotein (AFP). These methods are not sufficient for early diagnosis and so additional markers are needed.
Recent studies show that some miRNAs are located at fragile sites and genomic regions involved in cancers. The aberrant expression of miRNA genes could lead to human disease, including cancer and are regarded as potential biomarkers for cancer diagnosis. Emerging evidence indicates that miRNAs are often deregulated in HCC, and that some specific miRNAs are associated with the clinicopathological features of HCC. So, identifying the miRNAs and their targets may provide promising diagnostic and therapeutic opportunities.
The aim of this work was to clarify the significance of circulating microRNAs for early detection of hepatocellular carcinoma.
The present study was conducted on 50 subjects. They were selected from Hepatology&Gastroentrology department, Benha University hospital and were allocated in 3 groups:
1-Group I: this group consisted of 10 normal healthy persons served as control group.
2-Group II: this group consisted of 20 patients previously diagnosed as liver cirrhosis based on clinical, laboratory, ultrasonography and /or liver biopsy.
3-Group III: this group consisted of 20 patients with HCC stage 0, A according to Barcelona Clinic Liver Cancer (BCLC) and Milan criteria & confirmed by spiral triphasic CT scan, elevated alpha - feto protein (AFP) level, and liver biopsy.
A peripheral venous blood sample was obtained from all subjects after their consent under complete aseptic conditions and maximum precautions.
The obtained results showed that genetic expression of miRNA 224 and miRNA 885 was significantly increased in cirrhosis compared to control and more significantly increased in HCC compared to cirrhosis and controls.
MiRNA 224 was found to be the most sensitive in early diagnosis of HCC with sensitivity and specificity were 95%, 93,3% respectively while sensitivity and specificity of miRNA 885 were 85%, 93.3% respectively and that of AFP were 65%, 100% also we found that combined use of both new markers (miRNA 224, miRNA 885) increase the sensitivity and specificity to 100%, 93.3% respectively.
Furthermore we found that genetic expression of miRNA 224 was more significantly increased than miRNA 885 expression.
As regard correlation between miRNA 224, miRNA 885 and liver function parameters, our results showed that there were a significant correlation between increased expression of miRNA 244, 885 and AFP (P <0.001). no correlation between them and liver parameters (albumin, bilirubin, AST, ALT).
Conclusion:
In conclusion, Detection and quantification of circulating miRNA 224 and miRNA 885 combined with AFP are useful for early detection of HCC screening in high risk vulnerable subjects, and prognostication.