الفهرس 
Liver cirrhosisOnly 14 pages are availabe for public view
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Abstract
It has been reported that, the level of serum B2M is elevated in patients with chronic hepatitis C and HCV-related HCC when compared to HCV-negative patients or healthy donors. Our study aimed to determine the clinical utility of serum β2M this as a marker for disease progression in chronic hepatitis C and in HCC patients (Ouda et al., 2015).
To elucidate our aim, this case-control study was conducted on 136 persons included 22 patients with chronic HCV (GI), 70 patients with liver cirrhosis (GII), 25 patients with hepatocellular carcinoma (GIII), and 19 healthy persons (GIV) of matched age and sex as controls. Patients and controls were selected from inpatients and outpatient’s clinic of the Tropical Medicine department, Menoufia university hospitals in the period between January 2019 and January 2020.
Patient and controls were subjected to careful medical history, full clinical examination, laboratory investigations specially measurement of serum B2 microglobulin levels and imaging studies. CBC liver function (ALT, AST Bilurbin- Albumin – protrsohronbin) AFP kidney function (urea – creatinin) ultrasonography – C.T.
Data were statistically analyzed using SPSS (statistical package for social science/IBM, Chicago, USA) program version 21 for windows. P-value < 0.05 considered statistically significant.
Statistical analysis of the present data revealed the following:
There was no statistically significant difference among studied groups regarding to age and gender.
There was statistically highly significant difference among the studied patients as regard jaundice, pallor, ascites, encephalopathy, LL oedma and ecchymosis.
Summary
Regarding ultrasonographic findings, there were statistically highly significant difference among the studied patients as regard liver size and echogenicity, hepatic focal lesions, splenic size and portal vein diameter.
There was statistically highly significant difference among the studied patients as regard CBC and kidney function tests.
Serum ALT and AST levels were significantly increased among child C and HCC than other studied patients while, serum albumin level was significantly higher among CHCV and child A than the other patients. Moreover, INR was significantly increased among child C patients than other studied patients while, alpha-fetoprotein was significantly increased among HCC patients than CHCV and cirrhosis patients.
B2 microglobulin was significantly lower among control, CHCV and cirrhosis patients than HCC group. Also, it was significantly higher among child C than child A, B and CHCV patients, with p value ˂0.001.
There were significant negative correlations between B2 microglobulin and platelets count, serum albumin in group I and with platelets count only in group IIc (p<0.001), and positive correlations with WBCs, ALT, AST, INR, alpha-fetoprotein, splenic and PV diameters among group I (p<0.05). In group II a,b B2 microglobulin was significantly correlate with Hb, ALT, AST, serum albumin, INR, splenic and PV diameter (p<0.05). Also, B2 microglobulin was significantly correlate with most parameters among group IIc (P<0.05). In HCC group (G III), there was positive correlations between B2 microglobulin and Hb, WBCs, AST, ALT, and alpha-fetoprotein.
ROC curve analysis showed that, among all the studied groups, the cutoff value of B2M was 6.3 with sensitivity of 72% and specificity of 62.9% at AUC of 0.73. It had sensitivity of 75%, specificity of 73% at AUC of 0.60 with cut off value 3.8 among chronic HCV and sensitivity of 79%, specificity of 70% at AUC of 0.64 with cut off value 7.11 among cirrhotic patients.
Summary
Moreover, it had sensitivity of 87%, specificity of 63% at AUC of 0.71 with cut off value 8.7 among HCC patients.
The AUC increased significantly to 0.921 among combined B2M and AFP estimation for HCC diagnosis and the sensitivity was 91%, specificity of 79.6%.