الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 165 |  |  |
| | | from | 165 | | |
Abstract
Hepatitis B and C viruses represent the major reason of
hepatocellular carcinoma in patients. The other risk factors are
related to infection of food with toxic materials such as
aflatoxin B1. In Egypt, HCV showed highest prevalence
infection with majority of genotype 4 which is associated with
HCC and cluster subtype 40.
The current study was conducted on 50 patients
classified into 3 groups. All clinicopathologic characteristics of
patients were collected.
group I: Patients with HCV-related HCC (n=30) who had
focal hepatic lesion detected on ultrasonographic
examination among patients with HCV-cirrhosis and were
diagnosed as primary HCC according to their spiral CT
findings and/or their histopathological examination.
group II: Patients with hepatitis C cirrhosis (n=10) who were
diagnosed by clinical, laboratory, ultrasonographic and
histopathological evidence of liver cirrhosis (negative
fibrosis).
group III: Patients with hepatitis C fibrosis (n=10) who were
diagnosed by clinical, laboratory, ultrasonographic and
histopathological evidence of liver fibrosis.
The mean age of the studied subjects is 59.7±7.6; range
44-77 years, the age of HCC group predominantly range 48 -70
years. Male gender predominates among HCV associated HCC
group, they constitute 69% in comparison to 48% for females.
Evaluating the serum AFP levels among the HCV
associated HCC group; the current results showed that only
43% of patients showed high AFP levels which exceeds
500U/ml, otherwise; the majority 67% showed levels <500U/ml. Regarding the liver function tests; it was found that
the majority of HCC associated HCV group had ALT and AST
enzymes activity above 100U/ml, however; minor cases below
this range. 53.3% of the HCC group had serum albumin levels
≤3.5 gm/dl.
Levels of OPN gene expression and Pokémon gene
expression were significantly higher in group I when compared
to all HCV patients. group I also showed significantly higher
serum levels of NO and MDA than when compared to all HCV
patients. On the other hand, group I showed lower serum levels
of caspase compared to group II and III.
There was a significantly higher difference in group III
(HCV-CLD / +ve fibrosis) than group II (HCV-CLD / -ve
fibrosis) in levels of OPN and Pokémon gene expression. Group
III also showed significantly higher serum levels of caspase and
MDA than the other 2 groups. group III showed lower serum
levels of NO.
HCC patients showed a significantly higher gene
expression of OPN in grade III when compared to grade I and II
Also, OPN expression was higher in patients whose serum level
of ALP exceeded 100 U/ml than in patients whose serum level
of ALP <100 U/ml. Pokémon gene expression was significantly
higher in grade III HCC patients compared to grade I and II.
Also, Pokémon expression was higher in patients whose serum
level of AFP exceeded 500 U/ml than patients whose serum
level of AFP below 500 U/ml.
In order to analyse the effect of HCV infection and
fibrosis on the measured parameters; comparative analysis was
conducted between HCV positive group (n=30) and a
combination of group II and group III (n=20), moreover,
between group II and III to evaluate the impact of fibrosis on the levels of the studied variables. High significant differences
were observed for OPN and Pokémon genes expression, NO,
MDA and caspase (p<0.01) between group I vs II and III and
group II vs III. Higher levels were observed in HCV positive
patients and hepatic fibrosis.
OPN gene expression was significantly correlated to serum
levels of AFP, caspase and NO in the HCV associated HCC
group. Its expression levels also were correlated to levels of
Pokémon gene expression. There was no correlation between
expression of either OPN or Pokémon and the other measured
parameters in HCV cirrhosis with fibrosis group.