الفهرس 
LIVER CIRRHOSISOnly 14 pages are availabe for public view
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Abstract
C
hronic liver diseases and their complications constitute a major health problem all over the world and especially in our country. Most of the morbidity and mortality of chronic liver diseases is due to its progression to cirrhosis and complications of cirrhosis.
Ascites is a frequent complication of advanced liver cirrhosis. Over 50% of cirrhotic patients develop ascites.
Hepatocellular carcinoma (HCC) is the most common cause of primary liver neoplasms and the fourth most frequent type of cancer worldwide.
The cancer antigen CA -125 is a high molecular mass glycoprotein produced both by ovarian cancer cells as also by normal cells of tissues derived from coelomic epithelium. Serum CA-125 levels are used as a marker of tumour activity in patients known to have ovarian carcinoma thus may be used to monitor disease progression or assess the effects of therapy in such patients.
Some studies reported that there is a correlation between serum levels of CA-125 and benign conditions including liver diseases especially those with advanced liver cirrhosis. Also, revealed that it`s much higher in patients with ascites due to liver cirrhosis in whom CA-125 detected in serum.
Other studies found that CA-125 levels are high in sera of patients with hepatocellular carcinoma (HCC).
This study was designed to assess the association between elevated levels of serum cancer antigen (CA-125) and progression of liver disease, also to explore the association between serum level of CA-125 in decompensated post-hepatitic HCV cirrhosis with or without ascites, and to assess the serum level of CA-125 in hepatocellular carcinoma.
It was held in Internal Medicine Department, Ain Shams University Hospital in the period from November 2011 to December 2012.
For better assessment, this study included number of (60) cases. They were divided into main three groups; Group A; 20 patients post-hepatitic HCV liver cirrhosis without ascites and Group B; 20 patients post-hepatitic HCV liver cirrhosis with ascites and Group C; patients diagnosed as hepatocellular carcinoma on top of post-hepatitic HCV liver cirrhosis.
All the studied cases were subjected to the following: careful medical history taking, full physical examination, and laboratory investigations including CBC, liver function tests, coagulation profile and serum CA-125. Abdominal ultrasonography & CT scan for HCC cases were done. The Child-Pugh & MELD were calculated too.
The results revealed increase serum levels of CA-125 in all studied groups.
Also revealed statistical heighly significant difference between group A (compensated cirrhosis) & group B (decompensated cirrhosis) concerning serum level of CA-125 being higher in group B, and there also a statistical significant difference between groups B & C being higher in group B. There wasn`t any significant difference between groups A & C.
So, serum CA-125 levels increase in cases of liver cirrhosis and is closely related to the progression of liver disease especially in the presence of ascites.
Serum AFP is a better marker of HCC sensitivity 75% specifity 95% than, serum CA-125 sensitivity 65% specifity 47.5%.