الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancers, and about 782,000 new cases were diagnosed worldwide in 2012. It is the second most common cause of mortality due to malignancy, with annually around 745,000 deaths worldwide.
Several causes can lead to HCC development such as chronic hepatitis B and C infection, non-alcoholic liver disease, aflatoxins, alcohol, hemochromatosis, alpha-1-antitrypsin deficiency and Wilson’s disease. These risk factors promote formation of cirrhosis, which is the main cause for HCC. In Egypt, chronic HCV is a major health problem with high prevalence of viral infection and the development of HCC.
The clinical picture of HCC is variable; sometimes asymptomatic, only patients discovered accidentally and most of the clinical picture is related to their chronic liver disease. Also, patients are sometimes presented with acute decompensation of previously compensated liver condition as jaundice, ascites, hepatic encephalopathy and bleeding.
Several guidelines have recommended HCC surveillance for cirrhotic patients at high risk, by ultrasound abdomen to detect focal hepatic lesion every six month. No role for the serum AFP in HCC surveillance in recent guidelines.
An aggressiveness score was established in the aim to assess the aggressiveness of HCC and to predict the prognosis. It includes serum AFP, maximum tumor diameter, number of nodules and the presence of portal vein thrombosis.
The present study aimed to assess some laboratory parameters that may contribute in the aggressiveness of HCC and to predict the aggressive form in the diagnosis of HCC in HCV-related cirrhotic patients. This study was conducted on 173 patients who were admitted to Hepatobiliary Unit, Internal Medicine Department, Alexandria Main University Hospital. They were divided into two groups.