الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
HCC is one of the most common cancers worldwide. In Egypt, it represents the 4th most common cancer. Cirrhosis, which is a precancerous condition, is the most important risk factor for the development of HCC. The most common etiologies of chronic liver disease and cirrhosis associated with HCC include HBV, HCV, alcohol-induced cirrhosis, and NASH. Treatment of HCC predominantly depends on cancer stage, underlying liver function, and PS. The most widely adopted staging system is the BCLC algorithm, which links prognosis of HCC with the best treatment option based on strong clinical evidence. One of the loco-regional interventional therapies, that play a major role in the current therapeutic management of HCC, is MWA. It uses dielectric hysteresis to heat tissues to lethal temperatures from an applied electromagnetic field which causes water molecules to rotate billions of times per second resulting in heat generation and cellular death via coagulation necrosis. Despite the significant improvements in the treatment strategies, the prognosis of HCC remains unsatisfactory. Thus, novel clinicopathological or molecular prognostic factors are needed to predict tumor biology and identify patients with higher risk of metastasis or recurrence. The hUTP14a, a member of the UTPs family, is a nucleolar protein, which plays an important role in 18S rRNA processing. It binds to the tumor suppressor protein p53 and promotes its protein degradation. Loss of function of p53 results in unregulated replication of defective DNA, genomic instability and progression to cancer.
The aim of the work was to evaluate the role of hUTP14a as a predictor for HCC recurrence after treatment with MWA.
This study was conducted in the Hepatobiliary Unit, Internal medicine department, Alexandria main university hospital and included 26 patients suffering from HCC on top of liver cirrhosis, who are HCC stages 0 and A according to BCLC with CP class A or B.
Routine investigations were done including; CBC, blood urea level, serum creatinine, liver enzymes (AST and ALT), serum albumin, serum bilirubin, prothrombin time, AFP and viral markers (HCV Ab, HBsAg). To confirm the diagnosis of HCC, triphasic CT was done after initial assessment with abdominal US.
Histopathological examination of US guided fine needle aspiration from the tumor tissues and the non-tumor tissues were performed.
After undergoing MWA using the microwave generator (ECO-100E2, Nanjing ECO Medical Instrument Co, China), all patients were followed up for 1 year with triphasic CT. The hUTP14a expression was evaluated using immunohistochemistry in HCC tissue specimens and the correlation between hUTP14a expression and clinic-pathological variables were analyzed, as well as the relation between hUTP14a expression and HCC recurrence after MWA.
On studying the expression pattern of hUTP14a in HCC, hUTP14a showed significant high expression in HCC tumor tissues compared to corresponding non-tumor cirrhotic tissues (p<0.001), with an average expression score of 48.31±22.86 and 18.27±8.92 respectively. Concerning the relation between hUTP14a and recurrence of HCC after MWA, we concluded that tumoral hUTP14a expression is significantly higher in patients who experienced recurrence than those who didn’t experience recurrence after MWA (p<0.001). This proves the oncogenic potential of hUTP14a, as well as the prognostic significance of hUTP14a expression and its role as an indicative of HCC recurrence after MWA.