الفهرس 
Introduction and the Aim of WorkOnly 14 pages are availabe for public view
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Abstract
The present study was conducted on patients suffering from liver cirrhosis and HCC. The patients were admitted to Mansoura University Hospital during the period from October 2003 to March 2006. Three groups of subjects were included in this study. ” A control group (n=20) 8 females and 12 males, their ages ranged from 39 to 68 years (mean age 54 8 years). ” Patients with liver cirrhosis group (n=82) 29 females and 53 males, their ages ranged from 35 to 71 years (mean age 50 9 years). ” Patients with hepatocellular carcinoma group (n=82) 28 females and 54 males, their ages ranged from 36 to 78 years (mean age 55 9 years). The cirrhotic patients were grouped according to Child classification A, B and C. The HCC patients were grouped according to Okuda classification I, II and III. Bood samples were withdrawn and serum samples were separated for estimation of liver functions, kideny function, anti HCV, HBsAg, IHA for bilharesiasis, ferritin, AFP, and AFP-L3. RNA was extracted from whole blood for detection of AFP mRNA. The buffy coat was collected for DNA extraction for detection of P16 methylation. Among 51 patients with liver cirrhosis (followed up by periodic examination with ultrasonography and measurement of serum AFP every 3 months), 6 patients developed HCC (11.7%). Results revealed significant increase in AFP and ferritin in cirrhotic group versus control. There were significant increase in AFP, AFP-L3%, AFP-L3 concentration and ferritin in HCC versus control group. Also, there were significant increase in AFP, AFP-L3%, AFP-L3 concentration and ferritin serum levels in HCC group versus cirrhotic group. In cirrhotic group, 2/14 cases of Child A and 4/4 cases of Child C were positive for AFPmRNA. On the other hand, all cirrhotic groups were negative for p16 methylation. In HCC group, 2/6 cases of Okuda I, 6/12 cases of Okuda II and 2/6 cases of Okuda III are positive AFP mRNA. On the other hand, 4/12 cases of Okuda III positive p16 methylation. In HCC group there were positive significant correlations between AFP and AFP-L3%, AFP-L3 concentration, ALP and ferritin. Also there was positive significant correlations between ferritin and ALP and AFP. In cirrhotic patients, there were positive significant correlations between AFP, AFP-L3% and AFP-L3 concentration. Conclusions: ” AFP-L3% had higher sensitivity and specificity than AFP. ” The detection of P16 methylation had lowest sensitivity and highest specificity. ” AFPmRNA and methylated P16 in the blood of HCC patients were significantly correlated with higher AFP level (>100 ng/ml) and ferritin (>100 ng/ml). ” Presence of AFPmRNA in peripheral blood patients with HCC suggests the presence of carcinoma cells in the circulation. Recommendations: ” The use of more than one biochemical marker is recommended with abdominal sonography for early diagnosis of HCC. ” Further research, focusing on the new markers for noninvasive diagnosis of HCC is recommended.