الفهرس 
Liver CirrhosisOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third cause of cancer-related mortality worldwide. Its incidence is clearly arising comprised by the prevalence of major risk factors mainly hepatitis B and hepatitis C. The population at risk is composed of chronic liver patients at the stage of extensive fibrosis or cirrhosis.
Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules.
More than 80%of HCCs develop in Asian and African countries where between 40% and 90% of HCCs are attributable to chronic hepatitis B.
In Africa, exceptionally in Egypt, HCV is the most leading cause of HCC.
The Egypt Demographic and Health Survey (EDHS) report that HCV was estimated a prevalence of 14.9% for the sampled population of 11126 aged 15–59 in 2008. Prevalence increased with age, with 55–59 year olds showing a rate of 39.4%. Overall prevalence was 17.4% in males and 12.2% in females.
Monocyte chemoattractant protein-1 (MCP-1) or chemokine ligand 2 (CCL2) is one of the key chemokines that regulate migration and infiltration of monocytes/macrophages. Both CCL2 and its receptor have been demonstrated to be induced and involved in various diseases.
Myofibroblasts represent a key cell for extracellular matrix (ECM) remodeling that takes place during wound healing, fibrosis and cirrhosis. The main source of hepatic myofibroblasts is hepatic stellate cells (HSCs) Hepatic myofibroblasts produce a variety of chemokines including monocyte chemoattractant protein-1 (MCP-1)/CCL2.
Hepatic stellate cells (HSCs) obviously accelerate HCC growth and diminish the extent of central necrosis. Activated HSCs also enhance HCC progression through the release of different factors like cytokines, chemokines, or enzymes, tumor-associated macrophages (TAMs) can regulate tumor growth, angiogenesis, invasion, and metastasis. In addition, myofibroblasts secreted CCL2 also enhances the malignant phenotypes of HCC cells by up-regulating expression of invasion/metastasis associated genes
Aim of this work was to evaluate serum Monocyte Chemoattractant Protein-1 as a potential tumor marker for early detection of hepatocellular carcinoma
This study was carried out on 80 patients. They included 51 males and 29 females, their age ranged from 35 to 75 years. The patients were subdivided into two groups HCC group consists of 40 patients with liver cirrhosis and hepatocellular carcinoma and cirrhotic group consists of 40 patients with liver cirrhosis. In addition 10 healthy individual were enrolled as a control group (4 males and 6 females), their age ranged from 30 to 70 years.
There was highly significant statistical difference among studied groups regarding AFP and MCP1. There was higher level of AFP and MCP1 in HCC group patients than level of MCP1 in cirrhotic group patients and controls
There was a positive correlation between MCP1 and MELD score and Child score among HCC group patients. There was also a positive correlation between MCP1 and AFP.