الفهرس 
LIVER CIRRHOSISOnly 14 pages are availabe for public view
 |  | from | 137 |  |  |
| | | from | 137 | | |
Abstract
Chronic 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 both serum and ascitic fluid.
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 and ascitic fluid level of CA-125 in decompensated post-hepatitic HCV cirrhosis with ascites, and to assess the serum and/or ascitic fluid level of CA-125 in hepatocellular carcinoma.
It was held in Tropical Medicine Department, Ain Shams University Hospital in the period from October 2010 to October 2011.
For better assessment, this study was designed to be a case control trial design included number of (150) cases. They were divided into main three groups; group I; formed of 60 patients post-hepatitic HCV liver cirrhosis [30 cases without ascites (A) and 30 cases with ascites (B)]. And group II; formed of 60 patients diagnosed as hepatocellular carcinoma on top of post-hepatitic HCV liver cirrhosis [30 cases without ascites (C) and 30 cases with ascites (D). Control Group; formed of 30 healthy control [(E)].
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, ascitic CA-125 for those with ascites. Abdominal ultrasonography & CT scan for HCC cases were done. The Child-Pugh & MELD were calculated too.
Our results revealed increase serum levels of CA-125 in all studied groups in comparison to the controls.
Also revealed statistical significant difference between groups A & B concerning serum level of CA-125 being higher in group B, and there also a statistical significant difference between groups C & D being higher in group D.
There was a positive correlation between serum level of CA-125 and both of child score and ascitic level of CA-125 in groups B & D.
There wasn`t any significant difference between groups A & C or, between groups B & D concerning serum level of CA-125.
So, we concluded that 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.
Elevated serum CA-125 levels in cases of HCC are related to cirrhosis itself as underlying etiology for HCC rather than the malignant condition. Which also explained and supported the idea of that the elevation of serum and even the ascetic CA-125 antigen is mesothelial rather than tumoral origin.