الفهرس 
Statistical analysisOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) represents the fifth most common cancer in the world, and the third most frequent oncological cause of death .Chronic infections with the hepatitis B virus (HBV) and the hepatitis C virus (HCV) have been involved in about 80% of cases worldwide of HCC.
Many patients die from complications of severe cirrhosis without any active treatment .hence, patients with advanced liver disease, particularly cirrhosis, those at risk for HCC and should be screened every six months for its development. Unfortunately, surveillance programs are hindered by the poor performance of the
commonly used serum markers, namely, AFP, even in combination with abdominal ultrasound. Efforts have been and continue to be applied to the search for improved HCC biomarkers.
Serum SCCA levels have been used as an indicator of a variety of squamous cell carcinomas, and fortunately it’s levels were significantly elevated in HCC patients, compared to patients with cirrhosis and normal subjects, so this study aimed to evaluate the significance of Squamous cell carcinoma antigen serum level
in hepatocellular carcinoma and liver cirrhosis patients in relation to alpha-fetoprotein.
This study included 30 patients with HCC and 30 patients with liver
cirrhosis. In addition to 17 healthy adults, with matched age and gender, were included as controls. All individuals were subjected to clinical examination, abdominal ultrasonography, CT scanning or liver biopsy and laboratory investigations including complete blood count, renal functions tests, liver function tests, hepatitis viral markers (HBsAg and HCV Ab), serum alpha fetoprotein (AFP)
level, as well as serum level of squamous cell carcinoma antigen by enzyme linked immunosorbent assay.
The gained results showed that:
Demographic data show significant differences between cirrhotic patients, HCC patients, and control group (p<0.05) regarding age, and no significant differences between 3 groups (p>0.05) regarding gender Hepatitis C Ab was positive in group I & II as percent of 96.7% of patients in liver cirrhosis and HCC group but it was 0.0% in the controls. As for hepatitis B sAg +ve patients, they were 3.3% in group I and 0.0% in group II and III.
Hematological profile showed high significant difference (p<0.00 1) between the studied groups regarding hemoglobin and platelets, the lowest level were reported in patients with liver cirrhosis (mean value 9.9 and 90.9 respectively)
For liver functions, the mean value of liver enzymes (AST and ALT) was significantly higher among HCC group (group II) with high significant differences regarding AST and ALT (p<0.00 1) between the studied groups. Also there were moderate significant differences (p=0.0 1) in total bilirubin and high significant
differences (p<0.00 1) in direct bilirubin among studied groups. There were a high significant difference between three groups regarding serum albumin and PT% Renal function tests showed high significant differences (p<0.00 1) for urea but no
significant differences for creatinine (p>0.00 1).
Regarding AFP and SCCA level, there were high significant increase
(p<0.001) for AFP whereas SCCA showed no significant increase between any of the studied groups (p>0.05) with the highest levels were reported in HCC group (mean value was 2.0) in comparison with other two groups.
There were a significant positive correlation of Squamous cell carcinoma antigen concentration and urea & creatinine concentration (p<0.05) in liver
cirrhosis. Also, there were a significant positive correlation of alpha feto-protein level to AST and total bilirubin level (p<0.05) in liver cirrhosis group but in HCC
group, there were a significant positive correlation of alpha feto-protein level to platelet concentration.
In relation to tumor burden and size in HCC patients, AFP was significantly high in patients with tumor size >6 cm than in patients with tumor size <6 cm showing significant increase (p<0.05) whereas SCCA level was also higher in
patients with tumor size >6 cm but showed no significant difference between the two groups of HCC patients. Moreover, AFP was significantly high in patients with PV thrombosis than in patients without it but for SCCA; no significant difference was present between the two groups.
The receiver operating characteristic curve showed area under the curve (AUC) of SCCA was 0.56 (95% CI), the cut off value of 0.5 μg/L had sensitivity of 73% and specificity of 44%. The area under the curve (AUC) of AFP was 0.87 (95% CI), the significant cut off value of 258 μg/L had sensitivity of 60 % and specificity of 100%. On combination of the two cut off values the sensitivity was improved to 100% and the specificity was 47%.