الفهرس 
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Abstract
Hepatitis C Virus is a serious condition that, if untreated, can result in significant health problems.
Hepatocellular carcinoma is now the second leading cause of cancer deaths worldwide, The incidence of HCC is highest in Asia and Africa where the endemic high prevalence HCV strongly predisposes to the development of HCC.
Toll-like receptors are expressed by a wide variety of cell types including immune cells. They play a crucial role in the inflammatory and host defense response against microorganisms, activation of innate immunity. Furthermore, research suggests that various TLRs may function differently on different tumor cells act as potential novel targets for pharmacological intervention in HCC.
This retrospective, case-control hospital based study was conducted in Internal Medicine Department, Minia University Hospital from from January 2015 to September 2017.
This study included 88 patients who were divided into three groups :
group I : 40 patients with HCC on top of chronic hepatitis c were stratified according the Barcelona-Clinic Liver Cancer classification. Typical HCC feature on a dynamic image or alpha fetoprotein >200 ng/ml if the nodule was >2cm in cirrhotic liver or two typical HCC features of dynamic images if the nodule was between 1 and 2 cm in a cirrhotic liver.
group II: 33 patients with chronic hepatitis C . Diagnosis of HCV based on positive anti- HCV antibody by third generation enzyme-linked immunosorbent assay and have detectable HCV RNA by polymerase chain reaction.
group III (Case Controls): 15 apparently healthy volunteers; age and BMI matched with patient group were enrolled as controls after written informed consent was obtained. All had normal liver tests, negative serology for chronic viral hepatitis .
All the included patients were subject to:
a) Careful history taking and complete examination.
b) Investigations:
• Laboratory investigations include: Fasting and postprandial blood sugar, complete blood count, liver chemicals test, renal funcations, erythrocyte sedimentation rate ,hepatitis markers, hepatitis c RNA by PCR assay and alfa fetoprotein, serum TLR2 and serum TLR4 by Eliza.
• Radiological investigations include: Abdominal ultrasonography and abdominal triphasic spiral computarized tomography.