الفهرس 
Epidemiology and diagnosis of HCCOnly 14 pages are availabe for public view
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Abstract
T
he diagnosis of HCC was almost always made when the disease was advanced, when patients were symptomatic and presented with a variable degree of liver function impairment, At this late stage virtually no treatment had any chance of being effective or of significantly improving survival.
That’s why Transarterial chemoembolization (TACE) was introduced as a palliative treatment in patients with un-resectable HCC, it has become one of the most common forms of interventional therapy.
Procedure involves selective catheterization of the hepatic segmental arteries nourishing the HCC lesions and the application of iodide in the form of iodized oil as a radio-opaque contrast medium (lipiodol), mixed with a chemotherapeutic agent induces ischemic tumor necrosis while minimizing damage to the liver tissue.
The use of TACE to treat HCC began after Lipiodol was introduced as Chemotherapeutic agents carrier and an embolic agent.
Lipiodol is better than other embolic agents in that it’s not only has an embolic effects on smaller vessels, but also selectively remains more in tumor nodules for several weeks to over a year, and the anticancer drug is slowly released from Lipiodol and remains in high concentrations within the tumor for a prolonged period, and that expands the exposure of the neoplastic cells to chemotherapy.
Lipiodol and related compounds are products of the addition of iodine to double bonds of the unsaturated fatty acids.
The volume of (10ml-15ml) needed in the procedure of TACE represents a significant iodine load, a single dose contains 13,500 μg of free iodide, as well as 15-60 g of bound iodine that may be liberated to free iodide following administration which is 90-to-several-hundred-thousand-fold the daily recommended intake for adults (150 mcg).
Although required for thyroid hormone synthesis, excess intra-thyroid iodide can disrupt thyroid hormone regulation, resulting in acute or chronic thyroiditis, hypothyroidism, or hyperthyroidism which could be clinically or sub clinically, transient or permenant.
The aim of our study was the evaluation of the thyroid dysfunctions after TACE procedure using lipiodol for patients with HCV related hepatocellular carcinoma.
This study was conducted to group of 30 patients with proved diagnosis of HCV related HCC and subjected to TACE.
All patients were subjected to full history taking, clinical examination with special stress on thyroid disorders manifestations, and laboratory investigations included complete blood count, liver profile, serum AFP, renal profile.
Thyroid profile: free T3, free T4 and TSH was measured before TACE and one week, one month after TACE with re-history taking and clinical examination for manifestation of thyroid dysfunction.
In our study we found that using lipiodol in TACE procedure act as iodine lode and might cause thyroid dysfunction by hypothyroidism or hyperthyroidism.
The effect of TACE on our subjected patient was sub-clinically thyroid dysfunction, with no symptoms or signs found.
It was noticed that changes in some thyroid hormones after exposure to TACE could be in significant relation to ALT levels.
There was no significant relation between age, sex, child-class, residence and the changes found in thyroid hormones.