الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
HCC is the predominant form of primary malignancy of the liver. In many parts of the world including Egypt, it is one of the leading causes of cancer-related mortality.
Despite knowing the high-risk populations for HCC development, the lack of sensitive and specific biomarkers hinders early detection of the disease at a curable stage. Therefore, the identification of new diagnostic markers for HCC becomes a top priority.
The present study was designed to validate the role of serum Linc00152 expression in diagnosis of HCC in Egyptian patients.
In order to achieve this goal, 30 HCC patients (group I) were included in the study and were divided into two subgroups; group IA consisted of 15 patients with late HCC and group IB consisted of 15 patients with early HCC The diagnosis of HCC was based on serum levels of AFP, ultrasonography and tri-phasic CT. The study also included 15 cirrhotic patients without evidence of HCC (group II) and 15 healthy subjects as controls (group III).
All patients had thorough clinical evaluation. Abdominal ultrasonographic examination was performed to assess the characteristics of HCC. The severity of liver disease was graded as class A, B and C according to Child-Pugh classification. The HCC stage was assessed as Stage A, B, C and D using Barcelona Clinic Liver Cancer (BCLC) staging system.
The following investigations were performed for all patients and healthy subjects:
• Routine laboratory tests, including CBC and liver function profiles.
• Hepatitis virus markers including HCV antibody, HCV RNA by PCR and HBsAg.
• Serum AFP using commercially available ELISA kit.
• Total RNA was extracted from serum samples followed by reverse transcription real time PCR. Expression of serum Linc00152 was calculated using the comparative cycle threshold (CT) method (2–ΔΔCT).
Statistical analysis of the studied parameters showed the following results:
• Serum AFP level was significantly higher in group I and II compared to group III. Also it was higher in group IA compared to group II.
• Serum Linc00152 level was significantly higher in group I and II compared to group III. Also it was higher in group IA compared to group II and higher in group IB compared to group II.
• The sensitivity and specificity of serum AFP and serum Linc00152 expression levels as markers for the diagnosis of HCC have been determined by plotting a receiver-operating characteristic (ROC) curve.
• At the cut-off value of 22ng/ml, the sensitivity of serum AFP in detecting HCC has been estimated to be 66.33% while its specificity has been shown to be 60%.
• Linc00152 has a sensitivity of 90% and a specificity of 66.67% at the cut-off value of 5.023 for the diagnosis of HCC.
• Combined together, serum AFP (cut off value = 22ng/ml) and serum Linc00152 expression (cut off value = 5.023 ng/ml) had a sensitivity of 86.67% and a specificity of 80%.
Serum Linc00152 expression level is more sensitive biomarker in diagnosis of HCC than the traditional marker, AFP. When combined together, AFP and Linc00152 level showed better sensitivity and specificity in HCC diagnosis. Therefore, serum Linc00152 can be used as a useful additional biomarker, with AFP for screening of HCC among patients with liver cirrhosis.