الفهرس 
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Abstract
HCC is a major cause of morbidity and mortality; it is the sixth most common cancer world-wide, and the third leading cause of cancer related deaths. Its prognosis is poor and early detection is of great importance. The most common form of genetic variation between individuals is SNP which corresponds to a modification of a DNA sequence due to the change of a single nucleotide. GPX1 is an antioxidant enzyme related to prevention, repair and defense of damage caused by the constant presence of ROS. The GPX1 gene is located on chromosome3. Overall, 38 SNPs have been reported for GPX1. The most studied polymorphism is the Pro 198 Leu, due to its influence on GPX1 levels, (low activity). Also, this substitution has been implicated in increased risk to many types of cancer. This work aimed to assess the relationship between genetic polymorphism of GPX1 (rs 1050450) with different stages of fibrosis & with the development of HCC in patients chronically infected with HCV.
The study included 110 subjects classified into three groups.
group (A): included 30 patients with HCC on top of chronic HCV.
group (B): Included 50 patients with chronic HCV infection with different stages of fibrosis, subdivided into: subgroup B1: 24 patients with mild fibrosis and subgroup B2: 26 patients with moderate/severe fibrosis.
group (C): included 30 apparently healthy volunteers age and gender matched with the diseased groups served as control. SUMMARY 121 | P a g e
Exclusion criteria:
Other etiologies of liver cirrhosis & HCC were excluded such as: Hepatitis B, metabolic liver diseases, autoimmune liver diseases, Alcoholic liver diseases, fatty liver disease.
Inclusion criteria:
Hepatocellular carcinoma patients on to of Hepatitis C Virus infection, confirmed by HCV-PCR RNA assay. chronic Hepatitis C infection, confirmed by HCV-PCR RNA assay, with different stages of fibrosis confirmed by Fibro-scan.
All patients were selected from inpatient and outpatient clinics of National Liver Institute, Menoufia University. Written informed consent was obtained from all participants & they were subjected to the following:
Full history taking, full clinical examinations, Radiological investigation including U/S for tumor size, Triphasic CT and Transient elastography to asses liver stiffness, Child-Pugh classification for patient groups and Routine laboratory investigations including: CBC, Liver Function tests, HCV antibody and HBs Ag, αFP and Glutathione Peroxidase 1 polymorphism analysis by PCR- RFLP technique.
The results of this study revealed that:
• All studied groups were homogenous regarding age and gender, as there was a non-significant statistical difference among the studied groups.
• In this study, it was found that platelet count and hemoglobin level were significantly lower in HCC, mild and moderate/severe fibrosis patients compared with the control group, yet INR, AST, ALT, ALP, γGT, total and direct bilirubin were significantly higher in HCC and moderate/severe fibrosis patients.
• Regarding genotypes distribution; there was a non-significant statistical difference in the distribution of genotypes and alleles among the studied groups.