الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
Vascular endothelial growth factor (VEGF) is a major driver of physiological and pathological angiogenesis. VEGF is believed to play an important role in various liver diseases, including HCC. Vascular endothelial growth factor (VEGF) is a major angiogenic factor and is a prime regulator of endothelial cell proliferation . VEGF is a potent and specific mitogen for vascular endothelial cells that may be involved in tumor angiogenesis . In addition, VEGF is able to increase capillary permeability, dilate arteries and chemotactically attract monocytes.
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. HCC is one of the few tumors for which an etiological factor can be identified in most cases. Hepatocellular carcinoma is now a rather common malignancy in Egypt with usually develops on top of liver cirrhosis secondary to viral infection, as both hepatitis B and C viruses increased the risk of HCC in the Egyptian patients.
Tumor markers are substances synthesized and secreted by the malignant cells and they are not normally found and they are not biologically active if present as they present in much smaller amounts, few of them are produced in a sufficient large proportions, so they can be used as serum markers of tumors and they become helpful in screening, diagnosis and follow up of cases. Serum AFP concentrations have been shown to be most useful tumor marker with regards to HCC but it may be normal in up to 40% of patients (lack of sensitivity). It may be increased in hepatitis and HCC patients (lack of specificity).
The purpose of this study is to Evaluate the influence of the C936T polymorphism of the VEGF And Alfa feto Protein on HCC, HCV and Control. This study was performed on 75 patients, 75 individuals will be selected, regardless of gender, ethnicity and age, and distributed in three groups. group (1) - 25 individuals had HCC; Group( 2) - 25 individuals had HCV; group (3) - 25 individuals, the control group, without clinical and biochemical signs of HCC. We determined the levels of ALT, AST, ALP, T.bilirubin, D.bilirubin, albumin, Serum proteins, AFP and the C936T polymorphism of the VEGF for all cases together with history taking, clinical examination, viral markers, conventional US ,abdominal CT.
There are highly significant increase in (Alk.phos. ,GOT, GPT) and (WBC) , (PLT) activity in Positive gene C936T polymorphism of the VEGF in all patients with a (p value < 0.05),(p value < 0.001),(p value < 0.05).also there was a non significant decrease in other parameters in the of positive and negative gene C936T polymorphism of the VEGF activity in all patients with a (p value > 0.05) . the influence of the C936T polymorphism of the VEGF distribution of the studied groups showing that the number of Positive gene within control, HCV group and the HCC groups were 0/25 (0%), 3/25 (12%) and 11/25 (44%) respectively, showing that Positive gene have higher incidence of HCV and HCC infection than Negative gene , when compared to control group.
There was a non significant decrease in serum (AFP) activity in the untreated HCV infected group compared to control group with a (p value = 0.527) and there was a significant increase in serum (AFP) activity in the HCC group compared to control group with a (P value = 0.05) respectively .also there was a non significant decrease in serum (AFP) activity in the HCC group compared to untreated HCV infected group with a (p value = 0.203).There was a positive significant correlation between AFP and HCV(ab) in HCC group with a (P < 0.001). Also,There was a positive significant correlation between AFP and Age in HCV group with a (P < 0.05) but there were no significant correlation between serum AFP and other biochemical parameters (ALT, AST, ALP, T. bilirubin , D.bilirubin, albumin, and T.protein, creatinine, Hb, WBC, PLT ).
Also it was found that when considering a cutoff level of AFP at 3.39 ng/ml yields (best cut off level for the study) it has a sensitivity and specificity of 52％ and 40％, respectively.