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العنوان
Role of Fibroscan for Early Detection of Hepatocellular Carcinoma (HCC) in Hepatitis C Cirrhotic Patients /
المؤلف
Ebrahim, Ahmed El-Hosieny.
هيئة الاعداد
باحث / احمد الحسيني ابراهيم السيد
مشرف / مني احمد حلمي شحاته
مناقش / صبري عبد اللطيف ابو سيف
مناقش / منال فتحي هميسه
الموضوع
Tropical Medicine
تاريخ النشر
2019.
عدد الصفحات
145 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الطب (متفرقات)
تاريخ الإجازة
20/2/2019
مكان الإجازة
جامعة طنطا - كلية الطب - Tropical Medicine
الفهرس
Only 14 pages are availabe for public view

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from 201

Abstract

Introduction Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. In Egypt, the incidence of HCC has doubled in the past 10 years and it is now the second most incident and lethal cancer in men. Up to 20% of HCC cases do not produce AFP, it may increase as usual in chronic hepatitis and liver cirrhosis, so overlaps can cause diagnostic difficulties. Thus the identification of novel diagnostic markers for HCC remains an important goal for many researches around the world. The increased using of radiologic imaging, particularly ultrasound (US) examination, has led to much more frequent identification of nodules in the liver. Hepatocellular carcinoma (HCC) is increasingly associated with hepatitis C virus (HCV) prevalence worldwide specially in Egypt. Over the past 5–8 years, evidence has been accumulating in different countries that the incidence of HCC is rising. Traditionally, the care of patients with HCC has been undertaken by hepatobiliary physicians and surgeons, interventional radiologists, and oncologists. Currently, the tests used to diagnose HCC include radiology, liver biopsy, and α-fetoprotein (AFP) . Recently, multi variant analysis showed increasing ratio for HCC parallel to rising liver stiffness. Tissue stiffness is related to tissue composition. The presence of tissue stiffness is associated with pathology often represents an early warning sign for breast or prostate cancer. This implies that methods for estimating stiffness of tissues would add as a weapon in the medical arsenal. It is therefore of interest to measure the stiffness in an objective and noninvasive way, and techniques to estimate the mechanical response of deep tissues to external excitations have been proposed. Transient Elastography (TE), fibroscan is a novel rapid, noninvasive, and reproducible method for measuring liver stiffness (LS) . The principle is one in which a painless, mechanical impulse is delivered to the skin above the liver, using a low-frequency elastic wave. This produces a wave of mechanical deformation that propagates toward the liver. By monitoring the wave’s progression in real time, an echo graphic transducer determines the propagation speed. Waves propagate more quickly with lesser tissue stiffness. This study aimed to evaluate the role of fibroscan for early detection of HCC in hepatitis C cirrhotic patients. Patients and methods; The study was conducted on 50 HCV cirrhotic patients who were referred to Tropical Medicine Department; Tanta university, included in two groups of cross matched age and gender. 25 case with HCC (group I), and 25 patients without HCC (group1I) . An informed consent was obtained before persons were included in the study. An approval from the local research ethical committee was obtained. Inclusion criteria: Adult HCV cirrhotic patients above 18years, With or without Hepatocellular carcinoma(HCC). Exclusion Criteria; Patients with Hepatic encephalopathy. Ascites or pregnancy. Hepato renal syndrome or hepato pulmonary syndrome. Right side heart failure, (Liver congestion). Extra hepatic tumors. History of liver transplantation. Cholestasis. Hepatitis B patients. All patients were subjected to full and detailed history taking, complete clinical examinations, laboratory investigations as complete blood count, liver function tests [alanine transaminase (ALT), aspartate transaminase, alkaline phosphatase, γ-glutamyltransferase, AFP, serum albumin, and serum bilirubin], serum creatinine level, abdominal ultrasonography examination that suspect HCC diagnosis then confirmed by abdominal triphasic CT, Liver stiffness measurements (LSM) using fibroscan 406 (Echosens, Paris, France) were recorded. The results were expressed in kilopascal and correspond according to the manufacturer’s recommendations to the median of 10 validated measurements. The validity results also depend on two important parameters: (a) the interquartile range, which reflects the variability of the validated measures and should not exceed 30% of the median value; and (b) the success rate (the ratio of the number of successful measurements to the total number of acquisitions) should be at least 60%.