الفهرس 
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Abstract
Hepatocellular carcinoma HCC is now the sixth most common cause of cancer worldwide. The second leading cause of cancer death after lung cancer in men is HCC.
The most frequently used screening tests for HCC patients are hepatic ultrasound (US) with or without assessment of alpha-fetoprotein, but the diagnostic value of AFP is recently challenged due to its low sensitivity and specificity.
So the aim of this study was to evaluate the role of neuropilin 1 as a diagnostic marker of HCC in Egyptian cirrhotic patients.
The study was carried out on 60 Egyptian patients:
group A (HCC): 30 patients with Hepatocellular carcinoma.
group B (Cirrhotic): 30 patients with liver cirrhosis without Hepatocellular carcinoma.
For all participant in this study, full clinical assessment by history and physical examination in addition to laboratory haematological and biochemical assessment and confirmation of HCC diagnosis was done by triphasic CT on the abdomen, We assessed serum neuropilin 1 in all study participant.
In this study, we found that there was no significant difference between group A (HCC) and group B (cirrhotic) regarding (age, gender, smoking, DM, HTN).
We found that cut off point for Neuropilin 1 level to detect cases HCC was found >10.7with sensitivity of 96,67%, specificity of 80 % and area under curve (AUC) of 96%.
Being statistically significant higher in HCC group more than both cirrhotic group Neuropilin 1 was found slightly elevated in cirrhotic patients compared to HCC, suggesting that neuropilin 1 level increase in liver damage, however the significance was much lower than that from a comparison between the cirrhosis and hcc groups.
The results showed, there was no significant correlation between neuropilin1 and (age, WBC, platelet, HB, DM, HTN, INR, BUN, CR, NA, K, Total Bilirubin, Direct Bilirubin, child score) among both HCC group and cirrhotic group.
While there was statistically significant positive correlation between Neuropilin 1 and (AST, ALT, AFP, MELD) among all cases.
While there was statistically significant positive correlation between Neuropilin 1 and Barcelona score among HCC group.
While there was statistically significant negative correlation between neuropilin 1 and (albumin) among cirrhotic group and HCC group.
Neuropilin 1 is more sensitive and specific than AFP in differentiation between HCC and cirrhotic patients.
The presence of (neuropilin1) in blood is a biomarker of early stages of HCC.
Neuropilin 1 is a promising serum tumor marker for HCC diagnosis.