الفهرس 
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Abstract
This study was conducted on one handrerd cases of HCC ( chosen from minia university hospital ) as well as one handred patients with liver cirrhosis.
We aimed at evaluating the different risk factors that play role in pathogenesis of HCC. They were clinically assessed and investigated (Laboratory including liver biochemical profile, viral markers, AFP,and imaging that was mainly by abdominal ultrasonography&serum glucose&serum iorn &lipid profil). All HCC cases were confirmed according to BCLC diagnostic criteria.
We found that HCC commonly presented in males and the mean age was 52.5 years with a range between 20 and 73 years. Most of HCC cases were farmers with a higher incidence of unsafe water supply and higher exposure rate to pesticides. Heavy smoking proved to be statistically significant in contrast to smoking in general and alcoholism.
The chief complaint was abdominal pain and the dominant clinical finding was hepatomegaly.
Abdominal ultrasonography showed dominant occurrence of HCC on top of cirrhosis and higher incidence of the FHL to be single, large, hypoechoic and affecting the right lobe.
By study of risk factors of HCC,
High prevalence of HCV was found in HCC cases taking the upper hand nowadays. In contrast, we found that HBV, one of the major risk factors of hepatic carcinogenesis, has a declinig role in our cases with a lower prevalence of HBsAg and anti HBc in comparison to other studies.
Co association of both hepatitis viruses, which is a quite frequence, was not so much evident. This may be affected by the low prevalence of HBV in our caces
A small number of cases developed HCC on top of non cirrhotic liver. Most of them were affected by hepatitis viruses, and schistosomiasis.
In our study, 65% of HCC cases had a single major risk factor.
Finally, we concluded that HCC is multifactorial with many major risk factors ( cirrhosis, HCV) , minor risk factors ( pesticides, heavy smoking ) and schistosomiasis in pathogenesis of this malignancy. HBV infection, which was one of the major risk factors, was found to have a declining role in hepatocarcinogensis.