الفهرس 
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Abstract
common cancer in women in Egypt, where hepatitis C virus is endemic. Hepatitis C virus has been established as one of the most important determinants of HCC. In addition, occult hepatitis B virus and aflatoxin are documented as a risk factors of HCC.
The present work focused on study of the contribution of aflatoxin positivity and HBc positivity to the pathogenesis of 52 of HCC cases occurring as a complication of post hepatitic cirrhosis and 3/52 cases of HCC, on top of chronic HCV infection.
Occult HBV (HBcAg positivity) was detected in 26.9 % of the included HCCs. A significant direct correlation was detected between HBc Ag positive cases and tumor grade, and the presence of vascular invasion and multifocalty. Vascular invasion and multifocalty are a crucial finding in defining the stage of HCCs according to the TNM staging system, HBc Ag positivity may warrant a more closer surveillance strategy.
AFB1-DNA adduct was detected 38.5% cases of hepatocellular carcinoma. This sounds an alarm as to the fact that Egypt is soon to be considered one of the regions with high aflatoxin exposure rather than the low rate of exposure previously calculated. A significant positive correlation were observed between Aflatoxin B1 status and determinants of TNM stage and low grade tumor. This implies that Aflatoxin B1positivity imparts a more aggressive biological behavior to HCCs.