الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This lack of specificity diminishes the utility of circulating fibronectin as a diagnostic indicator of liver disease. Nevertheless, increasing circulating fibronectin levels remain a reliable indicator of sustained tissue damage. Perhaps tests for circulating fibronectin could be incorporated in a panel that includes tests for the more specific markers of hepatic damage, alanine aminotransferase (ALT) and gamma glutamyl transpeptidase (GGT), thus providing a means to determine whether a detected increase in circulating fibronectin levels is, in fact, related to liver disease . The aim of this study is to determine the serum fibronectin levels in the patients with (HCC) in comparison with its levels in the patients with chronic liver cirrhosis or healthy control, to detect its usefulness as a biomarker for (HCC).In the present study, fibronectin was detected and identified in serum samples of patients with HCC Patients using monoclonal antibody specific for fibronectin and western blot analysis technique. Serum samples of 239 (114 liver cirrhosis and 125 HCC) patients were tested by ELISA for the detection of fibronectin antigen against sera collected from 50 healthy individuals. Of the 125 sera with HCC analyzed at cutoff 400 µg/mL, 94 patients were positive for fibronectin antigen with detection rate 75.2 % and of the 114 sera from patients with liver cirrhosis 33 patients were positive for fibronectin antigen with detection rate 29.0 %, while all 50 serum samples from healthy individuals were negative for fibronectin antigen with detection rate 0.0%. There was extremely high statistically significant difference (X2 = 99.2) in the detection rates of fibronectin antigen in healthy individuals, patients with liver cirrhosis and those with HCC. Moreover, there was extremely high statistically significant difference (X2 = 51.2) in the detection rates of fibronectin antigen in patients with liver cirrhosis and those with HCC .In our current study we found that the molecular weight of the reactive band of fibronectin antigen was 90 kDa. Using ROC curve, we assessed the diagnostic accuracy (AUC) of fibronectin antigen represented between liver cirrhosis and HCC patients and it was equal 0.775. The cut-off of fibronectin antigen for liver cirrhosis vs. HCC was 400 µg/mL. On the other hand we found in the present study that diagnostic sensitivity and specificity of fibronectin were 75.2% and 71.0% respectively.Therefore, the serum fibronectin levels might be helpful for the diagnosis of HCC patients. Because many cancers develop in high risk patients with underlying diseases, such as is the case for HCC development in cirrhosis. The current data show that serum fibronectin levels were clearly elevated in HCC patients. The findings in the present study provided evidence that the surveillance of serum fibronectin concentration may be a non-invasive biomarker for the potential diagnosis of HCC patients.