الفهرس 
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Abstract
Hepatitis C virus (HCV) is a major aetiological agent of chronic liver disease worldwide, affecting an estimated 3% of the population. characteristic features of HCV infection include high incidence of persistence in the host and progression to chronic hepatitis, leading to cirrhosis, which is a strong risk factor for development of hepatocellular carcinoma.
Diagnosis of hepatocellular carcinoma is usually made by history, physical examination, imaging (ultrasound, Magnetic resonance imaging (MRI) or Computed tomography (CT) scan showing a liver mass consistent with HCC) and optionally elevated serum alpha fetoprotein (>400 ng/ml).
Clusterin is a secretory heterodimeric glycoprotein (75–80 kDa) expressed in several tissues and present in all human fluids. It has altered expression in different cancer tissues, and it plays a significant role in the tumor genesis of several types of human cancer, including HCC.
Serum clusterin is up regulated in HCC and more sensitive and specific than AFP for differentiating HCC patients from those with cirrhosis. Clusterin might be deemed as a useful biomarker for diagnosis and predicting the metastasis potential of HCC.
This study was aiming to evaluate the possible diagnostic role of serum Clusterin in detecting the occurrence of Hepatocellular carcinoma in patients with hepatitis C virus - related liver cirrhosis.
Patients were recruited from the internal medicine department (inwards and outpatient clinic) of Suez Canal University Hospital and normal healthy volunteers attending the blood bank.
A total of 87 individuals were studied and divided into four groups, group 1 included 12 normal healthy volunteers, group 2 included 25 patients with chronic hepatitis C virus patients, group 3 included 25 patients with hepatitis C virus - related liver cirrhosis and group 4 included 25 HCC patients with HCV-related liver cirrhosis.
All patients were clinically evaluated, had routine laboratory investigations and assessment of circulating levels of AFP and abdominal ultrasonography giving an attention to hepatobiliary system. Serum clusterin was determined in all samples by ELISA.
By analyzing and processing the data obtained from the history, clinical examination and lab work the study declared that:
The levels of serum clusterin were statistatically different between healthy and chronic HCV patients, liver cirrhosis patients and HCC patients (the mean levels of clusterin were 102.2 μg/mL, 138.6 μg/mL, 34.9 μg/mL and 75.8 μg/mL respectively, p<0.001) serum clusterin levels in HCC patients were lower than in those with chronic HCV and healthy subjects, but it was higher than in those with cirrhosis.