الفهرس 
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Abstract
Hepatocelluler carcinoma (HCC) is one of the predominant types of malignancy and ranks third in mortality worldwide.
Radiofrequency ablation (RFA) is regarded as an alternative to surgical resection for curative treatment of small HCC.
GGT is a key enzyme that catalyzes the transpeptidation and hydrolysis of the C- terminal glutamyl group of glutathione and related molecules, and it correlates with biotransformation, nucleic acid metabolism, and tumorigenesis. Recently, serum GGT level has also been characterized as biomarker for oxidative stress, and shown to correlate with inflammation in the extracellular tissue microenvironment. Over the last few years, several studies have focused on the possible relationship between GGT and the incidence of HCC development, recurrence, and poor prognosis.
We measured AFP and GGT 1-2 days before RFA and 2 months after.
This study was conducted on 20 patients with HCC who are treated by RFA and 20 healthy subjects as controls of matched age and sex. These patients with HCC who had been treated by RFA at Fever Hospital of Shieben El Kom between October 2014 and March 2015.
Patient and controls were subjected to careful medical history, full clinical examination, laboratory investigations including complete blood picture, liver function tests, renal function tests, viral markers, serum AFP level, serum GGT, imaging studies (abdominal ultrasonography and triphasic CT). The data were collected, tabulated, and analyzed.
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The present study revealed the following results:-
- There was non-significant difference between studied groups as regards age and sex.
- chronic HCV was the commonest etiology of HCC patients while chronic HBV was far less common etiology.
- There was non-significant difference between studied groups as regards INR, Total bilirubin, and it showed high significant difference as regards Albumin, ALT and AST.
- There was non-significant difference between studied groups as regards Hb and TLC and it showed high significant difference as regards platelets count.
-There was non-significant difference between studied groups as regards serum creatinine.
- There was significant difference between studied groups as regards AFP and high significant difference as regards GGT.
-There was significant difference between studied groups as regards AFP and GGT before and after treatment of HCC with RFA.
-There was significant difference between studied groups as regards AFP and GGT before and after treatment of HCC with RFA.
-There was no significant difference in mean values of AFP as regard tumor size in the HCC group. While there was statistical significant increase in the mean values of GGT with increasing the tumor size (more than 2 cm).
- At cut off point 6.05 ng/ml, AFP had sensitivity 85.0%, specificity 60.0%, accuracy 72.5% and negative predictive value was 80.0%, while for GGT at cut off point 49 IU/l, the sensitivity was 90.0%,
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specificity 75.0% , accuracy 82.0% and negative predictive value was 82.0% in diagnosis of HCC.
-Sensitivity increased to 100%, specificity was 35.0% and accuracy was 68.0% and negative predictive value increased to 100.0%.
- There was significant increase in sensitivity and negative predictive value with combined use of AFP and GGT than AFP alone as a prognostic marker in HCC treatment.